1
|
Manzoor M, Leskelä J, Pietiäinen M, Martinez-Majander N, Könönen E, Niiranen T, Lahti L, Sinisalo J, Putaala J, Pussinen PJ, Paju S. Shotgun metagenomic analysis of the oral microbiome in gingivitis: a nested case-control study. J Oral Microbiol 2024; 16:2330867. [PMID: 38528961 PMCID: PMC10962305 DOI: 10.1080/20002297.2024.2330867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/08/2024] [Indexed: 03/27/2024] Open
Abstract
Background Gingivitis, i.e. inflammation of the gums, is often induced by dentalplaque. However, its exact link to the oral microbiota remains unclear. Methods In a case-control study involving 120 participants, comprising 60 cases and 60 controls (mean age (SD) 36.6 (7.6) years; 50% males), nested within a prospective multicentre cohort study, we examined theoral microbiome composition of gingivitis patients and their controlsusing shotgun metagenomic sequencing of saliva samples. Participants underwent clinical and radiographic oral health examinations, including bleeding on probing (BOP), at six tooth sites. BOP ≥33%was considered 'generalized gingivitis/initial periodontitis'(GG/IP), and BOP <33% as 'healthy and localized gingivitis'(H/LG). Functional potential was inferred using HUMANn3. Results GG/IP exhibited an increase in the abundance of Actinomyces, Porphyromonas, Aggregatibacter, Corynebacterium, Olsenella, and Treponema, whereas H/LG exhibited an increased abundance of Candidatus Nanosynbacter. Nineteen bacterial species and fourmicrobial functional profiles, including L-methionine, glycogen, andinosine-5'-phosphate biosynthesis, were associated with GG/IP. Constructing models with multiple markers resulted in a strong predictive value for GG/IP, with an area under the curve (ROC) of 0.907 (95% CI: 0.848-0.966). Conclusion We observed distinct differences in the oral microbiome between the GG/IP and H/LG groups, indicating similar yet unique microbial profiles and emphasizing their potential role in progression of periodontal diseases.
Collapse
Affiliation(s)
- Muhammed Manzoor
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Jaakko Leskelä
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Milla Pietiäinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Industrial Biotechnology and Food Protein Production, VTT Technical Research Centre of Finland, Espoo, Finland
| | | | - Eija Könönen
- Institute of Dentistry, University of Turku, Turku, Finland
| | - Teemu Niiranen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Internal Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Leo Lahti
- Department of Computing, University of Turku, Turku, Finland
| | - Juha Sinisalo
- Heart and Lung Center, Helsinki University Central Hospital, and Helsinki University, Helsinki, Finland
| | - Jukka Putaala
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Pirkko J. Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Susanna Paju
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| |
Collapse
|
2
|
Sahni V, Van Dyke TE. Immunomodulation of periodontitis with SPMs. FRONTIERS IN ORAL HEALTH 2023; 4:1288722. [PMID: 37927821 PMCID: PMC10623003 DOI: 10.3389/froh.2023.1288722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
Inflammation is a critical component in the pathophysiology of numerous disease processes, with most therapeutic modalities focusing on its inhibition in order to achieve treatment outcomes. The resolution of inflammation is a separate, distinct pathway that entails the reversal of the inflammatory process to a state of homoeostasis rather than selective inhibition of specific components of the inflammatory cascade. The discovery of specialized pro-resolving mediators (SPMs) resulted in a paradigm shift in our understanding of disease etiopathology. Periodontal disease, traditionally considered as one of microbial etiology, is now understood to be an inflammation-driven process associated with dysbiosis of the oral microbiome that may be modulated with SPMs to achieve therapeutic benefit.
Collapse
Affiliation(s)
- Vaibhav Sahni
- Immunology and Infectious Disease, The Forsyth Institute, Cambridge, MA, United States
| | - Thomas E. Van Dyke
- Immunology and Infectious Disease, The Forsyth Institute, Cambridge, MA, United States
- Faculty of Medicine, Harvard University, Boston, MA, United States
| |
Collapse
|
3
|
Ravindran N, Sudhakar U, Mithradas N, Suresh S, Asirvatham SL, J S, Kotaru JL, A B, K R S, B B. Insight Into the Laboratory Diagnosis of Periimplantitis Using Reactive Oxygen Metabolite Levels - A Biochemical Study. Cureus 2023; 15:e41324. [PMID: 37539392 PMCID: PMC10396069 DOI: 10.7759/cureus.41324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Aim The study aims to substantiate the quantitative role of the predominant periodontopathogen (Porphyromonas gingivalis) associated with peri-implantitis and evaluate the reactive oxygen metabolite levels in peri-implantitis patients. Methodology A total of 40 participants were taken from the department of periodontology, Thai Moogambigai Dental College and Hospital, Chennai, and divided into groups I (control) and II (test). Group I included 20 participants with healthy peri-implant tissue, and group II included 20 participants with infected peri-implant tissues. The predominant periodontopathogen was detected by using a quantitative real-time polymerase chain reaction. Samples (gingival crevicular fluid (GCF), saliva, and plasma) were collected, and a biochemical assay was conducted for reactive oxygen metabolites (ROM) analysis in healthy implants (control group) and peri-implantitis conditions (test group). ROM levels of the patients were statistically analyzed. Results The qualitative and quantitative profiles of Porphyromonas gingivalis (P. gingivalis) associated with Peri-implantitis were analyzed, and the levels of ROM in periimplantitis patients were assessed. The study results substantiate the quantitative picture of Porphyromonas gingivalis in the detection of periimplantitis. The saliva and GCF samples showed significant differences in ROM levels between the test and control groups. Conclusion This is one of the few studies to detect the predominant bacterial pathogen associated with peri-implantitis and assess the ROM levels in periimplantitis patients. The study gives a correlation between the periopathogens and ROM levels, thereby facilitating the attainment of the best possible treatment options.
Collapse
Affiliation(s)
- Navina Ravindran
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Uma Sudhakar
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Nimisha Mithradas
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Snophia Suresh
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | | | - Steffy J
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Jhansi L Kotaru
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Bakkiya A
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Sundaran K R
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Bhavishya B
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| |
Collapse
|
4
|
Slavkin HC, Dubois PA, Kleinman DV, Fuccillo R. Science-Informed Health Policies for Oral and Systemic Health. J Healthc Leadersh 2023; 15:43-57. [PMID: 36960302 PMCID: PMC10028303 DOI: 10.2147/jhl.s363657] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023] Open
Abstract
Oral, dental and craniofacial (ODC) health has a profound impact on general health and welfare throughout life, yet US dentists and physicians operate across misaligned silos. This protracted division limits access to optimal health, supports fee for services, and exacerbates health disparities. Early in the 20th century, the most frequent dental therapy was tooth extraction: removed infected teeth were substituted by prosthetic appliances - commonly, dentures or nothing. Most adults assumed becoming edentulous was a normal corollary of aging. With the discovery of penicillin and other antibiotics, healthcare professionals and policy makers predicted infectious diseases would become irrelevant. However, given numerous health threats, including SARS-CoV-2, HIV, multidrug-resistant bacteria, Zika virus, Ebola virus, and now monkeypox, public and professional awareness of transmissible infectious diseases has never been more evident. Ironically, little attention has been paid to unmet transmissible, infectious, common oral diseases - dental caries and periodontal diseases. Therefore, these persist within "the silent and invisible epidemic". The preventable death of a young boy in 2007 from an infected untreated tooth that produced bacterial meningitis is a profound reminder that our nation has vast inequities in education, health, and welfare. The impact of oral infections on hospital-acquired pneumonia, post-operative infection in cardiac valve surgery, and even academic performances of disadvantaged children displayed through sociodemographic characteristics and access to care determinants also are profound! This paper asserts that current and emerging ODC health knowledge and science will inform health policies and advance equity in access to care, affordable costs, and optimal healthcare outcomes. We recommend that legal and regulatory systems and public health programs be required to ensure health equity. A fair healthcare system that addresses holistic healthcare must be transparent, accessible, integrated and provide a standard of oral healthcare based upon scientific evidence for all people across the lifespan.
Collapse
Affiliation(s)
- Harold C Slavkin
- Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Peter A Dubois
- California Dental Association, California Dental Association Holding Company, Inc., Sacramento, California, USA
| | | | - Ralph Fuccillo
- Cambridge Concord Associates, Stoneham, Massachusetts, USA
| |
Collapse
|
5
|
Microbiota in Periodontitis: Advances in the Omic Era. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:19-43. [DOI: 10.1007/978-3-030-96881-6_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
6
|
LaMonte MJ, Andrews CA, Hovey KM, Buck MJ, Li L, McSkimming DI, Banack HR, Rotterman J, Sun Y, Kirkwood KL, Wactawski-Wende J. Subgingival microbiome is associated with alveolar bone loss measured 5 years later in postmenopausal women. J Periodontol 2021; 92:648-661. [PMID: 33141988 PMCID: PMC8089116 DOI: 10.1002/jper.20-0445] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/18/2020] [Accepted: 09/29/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND The aim of this study was to quantify the association between subgingival microbiota and periodontal disease progression in older women, for which limited published data exist. METHODS A total of 1016 postmenopausal women, aged 53 to 81 years, completed baseline (1997 to 2001) and 5-year (2002 to 2006) dental exams that included probing depth, clinical attachment level, gingival bleeding, and radiographic alveolar crestal height (ACH). Baseline microbiota were measured in subgingival plaque using 16S rRNA sequencing. Associations between 52 microbiota we previously found statistically significantly associated with clinical periodontal disease at baseline, were examined with disease progression. The traditional Socransky microbiota complexes also were evaluated. Side-by-side radiograph comparisons were used to define progression as ≥2 teeth with ≥1 mm ACH loss or ≥1 new tooth loss to periodontitis. The association between baseline centered log(2) ratio transformed microbial relative abundances and 5-year periodontal disease progression was measured with generalized linear models. RESULTS Of 36 microbiota we previously showed were elevated in moderate/severe disease at baseline, 24 had statistically significantly higher baseline mean relative abundance in progressing compared with non-progressing women (P < .05, all); which included all Socransky red bacteria (P. gingivalis, T. forsythia, T. denticola). Of 16 microbiota elevated in none/mild disease at baseline, five had statistically significantly lower baseline abundance in non-progressing compared with progressing women (P < 0.05, all), including one Socransky yellow bacteria (S. oralis). When adjusted for baseline age, socioeconomic status, and self-rated general health status, odds ratios for 5-year progression ranged from 1.18 to 1.51 (per 1-standard deviation increment in relative abundance) for microbiota statistically significantly (P < 0.05) positively associated with progression, and from 0.77 to 0.82 for those statistically significantly (P < 0.05) inversely associated with progression. These associations were similar when stratified on baseline levels of pocket depth, gingival bleeding, ACH, and smoking status. CONCLUSIONS These prospective results affirm clearly that subgingival microbiota are measurably elevated several years prior to progression of alveolar bone loss, and include antecedent elevations in previously undocumented taxa additional to known Socransky pathogenic complexes.
Collapse
Affiliation(s)
- Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo - SUNY, Buffalo, New York, USA
| | - Christopher A Andrews
- Department of Ophthalmology, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo - SUNY, Buffalo, New York, USA
| | - Michael J Buck
- Department of Biochemistry, School of Medicine, University at Buffalo - SUNY, Buffalo, New York, USA
| | - Lu Li
- Department of Computer Science and Engineering, University at Buffalo - SUNY, Buffalo, New York, USA
| | - Daniel I McSkimming
- Department of Bioinformatics, University of South Florida, Tampa, Florida, USA
| | - Hailey R Banack
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo - SUNY, Buffalo, New York, USA
| | - Jane Rotterman
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo - SUNY, Buffalo, New York, USA
| | - Yijun Sun
- Department of Computer Science and Engineering, University at Buffalo - SUNY, Buffalo, New York, USA
| | - Keith L Kirkwood
- Department of Oral Biology, School of Dental Medicine, University at Buffalo - SUNY, Buffalo, New York, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo - SUNY, Buffalo, New York, USA
| |
Collapse
|
7
|
Systemic circulating inflammatory burden and periodontitis in adolescents. Clin Oral Investig 2021; 25:5855-5865. [PMID: 33759000 DOI: 10.1007/s00784-021-03891-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/12/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To analyze the association between systemic inflammatory burden of cardiovascular disease (CVD) risk and periodontitis in adolescents, including mediating pathways triggered by their common risk factors. MATERIALS AND METHODS Using a population-based sample study (n = 405) of Brazilian adolescents (17-18 years old), direct and mediation pathways triggered by "Socioeconomic Status," "Adiposity," Smoking, and "Blood Pressure" were modelled for the association between the "Systemic Circulating Inflammatory Burden of CVD Risk" (IL-1β, IL-6, IL-8, TNF-α) and the "Initial Periodontitis" (bleeding on probing (BoP), probing depth (PD) ≥ 4 mm, clinical attachment loss (CAL) ≥ 4 mm), both as continuous latent variables, using structural equation modeling. Sensitivity analysis was performed for the outcomes "Gingivitis" (visible plaque; BoP); "Moderate Periodontitis" (PD ≥ 5 mm and CAL ≥ 5 mm) and periodontitis (CDC-AAP case definition). RESULTS Higher "Systemic Circulating Inflammatory Burden of CVD Risk" was directly associated with higher "Initial Periodontitis" (standardized coefficient [SC] = 0.178, P value < 0.001). Lower "Socioeconomic Status" (SC = - 0.022, P value = 0.015) and Smoking (SC = 0.030, P value = 0.021) triggered the "Initial Periodontitis", mediated by "Systemic Circulating Inflammatory Burden of CVD Risk". Sensitivity analysis showed a dose-response relationship between "Systemic Circulating Inflammatory Burden of CVD Risk" and "Moderate Periodontitis" (SC = 0.323, P value = 0.021). CONCLUSIONS "Systemic Circulating Inflammatory Burden of CVD Risk" appeared as an underlying mechanism of early periodontal breakdown in adolescents, also triggered by social vulnerability and smoking. CLINICAL RELEVANCE The association between periodontitis and CVD in adulthood seems to establish much earlier in life than had been previously studied, giving impetus to preventive approaches focused on their common risk factors.
Collapse
|
8
|
Abusleme L, Hoare A, Hong BY, Diaz PI. Microbial signatures of health, gingivitis, and periodontitis. Periodontol 2000 2021; 86:57-78. [PMID: 33690899 DOI: 10.1111/prd.12362] [Citation(s) in RCA: 143] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The subgingival crevice harbors diverse microbial communities. Shifts in the composition of these communities occur with the development of gingivitis and periodontitis, which are considered as successive stages of periodontal health deterioration. It is not clear, however, to what extent health- and gingivitis-associated microbiota are protective, or whether these communities facilitate the successive growth of periodontitis-associated taxa. To further our understanding of the dynamics of the microbial stimuli that trigger disruptions in periodontal homeostasis, we reviewed the available literature with the aim of defining specific microbial signatures associated with different stages of periodontal dysbiosis. Although several studies have evaluated the subgingival communities present in different periodontal conditions, we found limited evidence for the direct comparison of communities in health, gingivitis, and periodontitis. Therefore, we aimed to better define subgingival microbiome shifts by merging and reanalyzing, using unified bioinformatic processing strategies, publicly available 16S ribosomal RNA gene amplicon datasets of periodontal health, gingivitis, and periodontitis. Despite inherent methodological differences across studies, distinct community structures were found for health, gingivitis, and periodontitis, demonstrating the specific associations between gingival tissue status and the subgingival microbiome. Consistent with the concept that periodontal dysbiosis is the result of a process of microbial succession without replacement, more species were detected in disease than in health. However, gingivitis-associated communities were more diverse than those from subjects with periodontitis, suggesting that certain species ultimately become dominant as dysbiosis progresses. We identified the bacterial species associated with each periodontal condition and prevalent species that do not change in abundance from one state to another (core species), and we also outlined species co-occurrence patterns via network analysis. Most periodontitis-associated species were rarely detected in health but were frequently detected, albeit in low abundance, in gingivitis, which suggests that gingivitis and periodontitis are a continuum. Overall, we provide a framework of subgingival microbiome shifts, which can be used to generate hypotheses with respect to community assembly processes and the emergence of periodontal dysbiosis.
Collapse
Affiliation(s)
- Loreto Abusleme
- Laboratory of Oral Microbiology, Faculty of Dentistry, University of Chile, Santiago, Chile.,Laboratory for Craniofacial Translational Research, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Anilei Hoare
- Laboratory of Oral Microbiology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Bo-Young Hong
- Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Patricia I Diaz
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA.,UB Microbiome Center, University at Buffalo, State University of New York, Buffalo, NY, USA
| |
Collapse
|
9
|
Wendland N, Opydo-Szymaczek J, Mizgier M, Jarząbek-Bielecka G. Subgingival microflora in adolescent females with polycystic ovary syndrome and its association with oral hygiene, gingivitis, and selected metabolic and hormonal parameters. Clin Oral Investig 2021; 25:1485-1496. [PMID: 32779013 PMCID: PMC7878225 DOI: 10.1007/s00784-020-03456-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/08/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Research studies suggest that polycystic ovary syndrome (PCOS) may influence the composition of the oral microflora in women. This study aimed to investigate factors affecting the number of selected periopathogens in a young cohort of females with PCOS and to assess the association between oral hygiene, subgingival microbiome, gingival health, and metabolic and hormonal parameters. MATERIALS AND METHODS Thirty-two subjects with PCOS and twenty-three healthy controls aged 15-19 years were examined periodontally by a calibrated dentist. A real-time PCR method was used for the identification of 9 subgingival microorganisms. Subjects with PCOS underwent blood tests for determination of FSH, LH, total testosterone, DHEA-S, estradiol, SHBG, fasting glucose, fasting insulin, and lipid profile. RESULTS Gingival index (GI), the proportion of bleeding sites (BOP%), probing depth (PD), and plaque index (PLI) did not differ significantly between cases and healthy age-mates. The control group had significantly higher levels of Peptostreptococcus micros and substantially greater percentage of subjects infected by Treponema denticola. Capnocytophaga gingivalis count was positively correlated with the level of estradiol, while the concentration of HDL-C was negatively correlated with the number of Aggregatibacter actinomycetemcomitans and orange complex bacteria. CONCLUSIONS PCOS in young patients was not associated with higher pathogenicity of subgingival biofilms. CLINICAL RELEVANCE Further studies are needed to explain the relationship between hormonal and metabolic abnormalities, subgingival microflora, and periodontal health in patients with PCOS.
Collapse
Affiliation(s)
- Natalia Wendland
- Department of Pediatric Dentistry, Chair of Pediatric Dentistry, Poznan University of Medical Sciences, 70 Bukowska Street, 60-812, Poznan, Poland
| | - Justyna Opydo-Szymaczek
- Department of Pediatric Dentistry, Chair of Pediatric Dentistry, Poznan University of Medical Sciences, 70 Bukowska Street, 60-812, Poznan, Poland.
| | - Małgorzata Mizgier
- Department of Dietetics, Faculty of Physical Culture in Gorzow Wielkopolski, Poznan University of Physical Education, 4-6 Orląt Lwowskich Street, 66-400, Gorzów Wielkopolski, Poland
| | - Grażyna Jarząbek-Bielecka
- Department of Perinatology and Gynecology, Division of Developmental Gynecology and Sexology, Poznan University of Medical Sciences, 22 Polna Street, 60-535, Poznan, Poland
| |
Collapse
|
10
|
Ebersole JL, Kirakodu SS, Gonzalez OA. Oral microbiome interactions with gingival gene expression patterns for apoptosis, autophagy and hypoxia pathways in progressing periodontitis. Immunology 2021; 162:405-417. [PMID: 33314069 DOI: 10.1111/imm.13292] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/12/2020] [Accepted: 11/14/2020] [Indexed: 12/11/2022] Open
Abstract
Oral mucosal tissues must react with and respond to microbes comprising the oral microbiome ecology. This study examined the interaction of the microbiome with transcriptomic footprints of apoptosis, autophagy and hypoxia pathways during periodontitis. Adult Macaca mulatta (n = 18; 12-23 years of age) exhibiting a healthy periodontium at baseline were used to induce progressing periodontitis through ligature placement around premolar/molar teeth. Gingival tissue samples collected at baseline, 0·5, 1 and 3 months of disease and at 5 months for disease resolution were analysed via microarray. Bacterial samples were collected at identical sites to the host tissues and analysed using MiSeq. Significant changes in apoptosis and hypoxia gene expression occurred with initiation of disease, while autophagy gene changes generally emerged later in disease progression samples. These interlinked pathways contributing to cellular homeostasis showed significant correlations between altered gene expression profiles in apoptosis, autophagy and hypoxia with groups of genes correlated in different directions across health and disease samples. Bacterial complexes were identified that correlated significantly with profiles of host genes in health, disease and resolution for each pathway. These relationships were more robust in health and resolution samples, with less bacterial complex diversity during disease. Using these pathways as cellular responses to stress in the local periodontal environment, the data are consistent with the concept of dysbiosis at the functional genomics level. It appears that the same bacteria in a healthy microbiome may be interfacing with host cells differently than in a disease lesion site and contributing to the tissue destructive processes.
Collapse
Affiliation(s)
- Jeffrey L Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA.,Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Sreenatha S Kirakodu
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Octavio A Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA.,Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
11
|
Hoare A, Wang H, Meethil A, Abusleme L, Hong BY, Moutsopoulos NM, Marsh PD, Hajishengallis G, Diaz PI. A cross-species interaction with a symbiotic commensal enables cell-density-dependent growth and in vivo virulence of an oral pathogen. ISME JOURNAL 2020; 15:1490-1504. [PMID: 33372193 DOI: 10.1038/s41396-020-00865-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/20/2020] [Accepted: 11/30/2020] [Indexed: 01/25/2023]
Abstract
Recent studies describe in detail the shifts in composition of human-associated polymicrobial communities from health to disease. However, the specific processes that drive the colonization and overgrowth of pathogens within these communities remain incompletely understood. We used in vitro culture systems and a disease-relevant mouse model to show that population size, which determines the availability of an endogenous diffusible small molecule, limits the growth, colonization, and in vivo virulence of the human oral pathogen Porphyromonas gingivalis. This bacterial pathogen overcomes the requirement for an endogenous cue by utilizing a cell-density dependent, growth-promoting, soluble molecule provided by the symbiotic early colonizer Veillonella parvula, but not produced by other commensals tested. Our work shows that exchange of cell-density-dependent diffusible cues between specific early and late colonizing species in a polymicrobial community drives microbial successions, pathogen colonization and disease development, representing a target process for manipulation of the microbiome towards the healthy state.
Collapse
Affiliation(s)
- Anilei Hoare
- Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, UConn Health, Farmington, CT, 06030, USA.,Laboratory of Oral Microbiology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Hui Wang
- Department of Basic and Translational Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Archana Meethil
- Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, UConn Health, Farmington, CT, 06030, USA
| | - Loreto Abusleme
- Laboratory of Oral Microbiology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Laboratory for Craniofacial Translational Research, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Bo-Young Hong
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, 06030, USA
| | - Niki M Moutsopoulos
- Oral Immunity and Inflammation Unit, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Philip D Marsh
- Department of Oral Biology, School of Dentistry, University of Leeds, Leeds, UK
| | - George Hajishengallis
- Department of Basic and Translational Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Patricia I Diaz
- Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, UConn Health, Farmington, CT, 06030, USA. .,Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, NY, 14215, USA. .,UB Microbiome Center, University at Buffalo, State University of New York, Buffalo, NY, 14215, USA.
| |
Collapse
|
12
|
Abstract
The last decade has witnessed unparalleled advances in our understanding of the complexity of the oral microbiome and the compositional changes that occur in subgingival biofilms in the transition from health to gingivitis and to destructive periodontal disease. The traditional view, which has held sway for the last 2 decades, that disease is characterized by the outgrowth of a consortium, or consortia, of a limited number of potentially pathogenic organisms, has given way to an alternative paradigm. In this new view, the microbiological changes associated with disease represent whole-scale alterations to the overall microbial population structure and to the functional properties of the entire community. Thus, and in common with other microbially mediated diseases of the gastrointestinal tract, the normally balanced, symbiotic, and generally benign commensal microbiome of the tooth-associated biofilm undergoes dysbiosis to a potentially deleterious microbiota. Coincident with progress in defining the microbiology of these diseases, there have been equally important advances in our understanding of the inflammatory systems of the periodontal tissues, their control, and how inflammation may contribute both to the development of dysbiosis and, in a deregulated state, the destructive disease process. One can therefore speculate that the inflammatory response and the periodontal microbiome are in a bidirectional balance in oral health and a bidirectional imbalance in periodontitis. However, despite these clear insights into both sides of the host/microbe balance in periodontal disease, there remain several unresolved issues concerning the role of the microbiota in disease. These include, but are not limited to, the factors which determine progression from gingivitis to periodontitis in a proportion of the population, whether dysbiosis causes disease or results from disease, and the molecular details of the microbial stimulus responsible for driving the destructive inflammatory response. Further progress in resolving these issues may provide significant benefit to diagnosis, treatment, and prevention.
Collapse
Affiliation(s)
- Mike A Curtis
- Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral& Craniofacial Sciences, King's College London, London, UK
| | - Patricia I Diaz
- School of Dental Medicine, UConn Health, Farmington, Connecticut, USA
| | - Thomas E Van Dyke
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, Massachusetts, USA
| |
Collapse
|
13
|
Van Dyke TE. Shifting the paradigm from inhibitors of inflammation to resolvers of inflammation in periodontitis. J Periodontol 2020; 91 Suppl 1:S19-S25. [PMID: 32441774 DOI: 10.1002/jper.20-0088] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 12/24/2022]
Abstract
An initial shift in our understanding of the basis of periodontal disease occurred early in the 2000s. The host response, rather than the bacterial burden, was the principal determinant of the disease. Microbial dysbiosis that occurs in periodontal disease results from a hyperinflammatory state in the host. A second shift in periodontal disease is taking place. This time in the realm of treatment strategies. Rather than targeting antimicrobials or inhibitors of individual inflammatory mediators, preclinical studies support using resolution pharmacology to convert the pro-inflammatory condition into a non-inflammatory one, thereby resolving both the local and systemic inflammation associated with periodontal disease. Here, I describe the bases for these shifts in paradigms.
Collapse
Affiliation(s)
- Thomas E Van Dyke
- Clinical and Translational Research, Forsyth Institute, Cambridge, MA.,Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA
| |
Collapse
|
14
|
Van Dyke TE, Sima C. Understanding resolution of inflammation in periodontal diseases: Is chronic inflammatory periodontitis a failure to resolve? Periodontol 2000 2020; 82:205-213. [PMID: 31850636 DOI: 10.1111/prd.12317] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Periodontitis is an infectious-inflammatory disease that results from loss of balance between the commensal microbiome and the host response. The hyper-inflammatory, uncontrolled inflammatory immune lesion promotes tissue damage and impedes effective bacterial clearance. In this review, the relationship between the microbiome and the inflammatory/immune response is explored in the context of a bi-directional pathogenesis; bacteria induce inflammation and inflammation modifies the growth environment causing shifts in the composition of the microbiome. Resolution of inflammation is an active, receptor-mediated process induced by specialized pro-resolving lipid mediators. Inflammatory disease may, therefore, be the result of failure of resolution. Failure to resolve inflammation coupled with resultant microbiome changes is hypothesized to drive development of periodontitis. Re-establishment of microbiome/host homeostasis by specialized pro-resolving lipid mediator therapy suggests that microbiome dysbiosis, the host hyperinflammatory phenotype, and periodontitis can be reversed.
Collapse
Affiliation(s)
- Thomas E Van Dyke
- Forsyth Institute, Cambridge, Massachusetts, USA.,Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Corneliu Sima
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| |
Collapse
|
15
|
Van Dyke TE, Bartold PM, Reynolds EC. The Nexus Between Periodontal Inflammation and Dysbiosis. Front Immunol 2020; 11:511. [PMID: 32296429 PMCID: PMC7136396 DOI: 10.3389/fimmu.2020.00511] [Citation(s) in RCA: 183] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/06/2020] [Indexed: 12/19/2022] Open
Abstract
The nexus between periodontal inflammation and the polymicrobial biofilm in the gingival sulcus is critical to understanding the pathobiology of periodontitis. Both play a major role in the etiology and pathogenesis of periodontal diseases and each reinforces the other. However, this nexus is also at the center of a significant conundrum for periodontology. For all mucosal polymicrobial biofilms, the most confounding issue is the paradoxical relationship between inflammation, infection, and disease. Despite significant advances made in both periodontal microbiology and periodontal pathobiology, the issue of which comes first, the inflammatory response or the change to a dysbiotic subgingival microbiota, is still debated. In this paper, we present a model for the pathogenesis of periodontitis based on the central role of inflammation and how this modulates the polymicrobial biofilm within the context of the continuum of health, gingivitis, and periodontitis. We propose a new model termed “Inflammation-Mediated Polymicrobial-Emergence and Dysbiotic-Exacerbation” (IMPEDE), which is designed to integrate into and complement the 2017 World Workshop Classification of Periodontitis.
Collapse
Affiliation(s)
| | - P Mark Bartold
- School of Dentistry, University of Adelaide, Adelaide, SA, Australia
| | - Eric C Reynolds
- Melbourne Dental School, The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
16
|
Grevich S, Lee P, Leroux B, Ringold S, Darveau R, Henstorf G, Berg J, Kim A, Velan E, Kelly J, Baltuck C, Reeves A, Leahey H, Hager K, Brittnacher M, Hayden H, Miller S, McLean J, Stevens A. Oral health and plaque microbial profile in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2019; 17:81. [PMID: 31842923 PMCID: PMC6916162 DOI: 10.1186/s12969-019-0387-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/04/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The oral microbiota has been implicated in the pathogenesis of rheumatoid arthritis through activation of mucosal immunity. This study tested for associations between oral health, microbial communities and juvenile idiopathic arthritis (JIA). METHODS A cross-sectional exploratory study of subjects aged 10-18 years with oligoarticular, extended oligoarticular and polyarticular JIA was conducted. Control groups included pediatric dental clinic patients and healthy volunteers. The primary aim was to test for an association between dental health indices and JIA; the secondary aim was to characterize the microbial profile of supragingival plaque using 16S rRNA gene sequencing. RESULTS The study included 85 patients with JIA, 62 dental patients and 11 healthy child controls. JIA patients overall had significantly more gingival inflammation compared to dental patients, as evidenced by bleeding on probing of the gingiva, the most specific sign of active inflammation (p = 0.02). Overall, however, there was a trend towards better dental hygiene in the JIA patients compared to dental patients, based on indices for plaque, decay, and periodontitis. In the JIA patients, plaque microbiota analysis revealed bacteria belonging to genera Haemophilus or Kingella elevated, and Corynebacterium underrepresented. In poly JIA, bacteria belonging to the genus Porphyromonas was overrepresented and Prevotella was underrepresented. CONCLUSION Increased gingival inflammation in JIA was independent of general oral health, and thus cannot be attributed to poor dental hygiene secondary to disability. The variation of microbial profile in JIA patients could indicate a possible link between gingivitis and synovial inflammation.
Collapse
Affiliation(s)
- Sriharsha Grevich
- Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA. .,Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA.
| | - Peggy Lee
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Brian Leroux
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Sarah Ringold
- 0000 0000 9026 4165grid.240741.4Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105 USA ,0000000122986657grid.34477.33Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000 0000 9026 4165grid.240741.4Center for Clinical and Translational Research, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
| | - Richard Darveau
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Gretchen Henstorf
- 0000 0000 9026 4165grid.240741.4Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
| | - Joel Berg
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Amy Kim
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Elizabeth Velan
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Joseph Kelly
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Camille Baltuck
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Anne Reeves
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Hannah Leahey
- 0000 0000 9026 4165grid.240741.4Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
| | - Kyle Hager
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Mitchell Brittnacher
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Hillary Hayden
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Samuel Miller
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000000122986657grid.34477.33Department of Genome Sciences, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000000122986657grid.34477.33Department of Medicine, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Jeffrey McLean
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Anne Stevens
- 0000 0000 9026 4165grid.240741.4Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105 USA ,0000000122986657grid.34477.33Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000 0000 9026 4165grid.240741.4Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
| |
Collapse
|
17
|
Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, Geisinger ML, Genco RJ, Glogauer M, Goldstein M, Griffin TJ, Holmstrup P, Johnson GK, Kapila Y, Lang NP, Meyle J, Murakami S, Plemons J, Romito GA, Shapira L, Tatakis DN, Teughels W, Trombelli L, Walter C, Wimmer G, Xenoudi P, Yoshie H. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2019; 89 Suppl 1:S74-S84. [PMID: 29926944 DOI: 10.1002/jper.17-0719] [Citation(s) in RCA: 328] [Impact Index Per Article: 65.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 03/11/2018] [Accepted: 03/12/2018] [Indexed: 12/21/2022]
Abstract
Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm-induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable "periodontitis patient" i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a "case" of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.
Collapse
Affiliation(s)
- Iain L C Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, UK
| | - Brian L Mealey
- University of Texas Health Science Center at San Antonio, USA
| | | | | | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Oral Medicine, Johann Wolfgang Goethe-University Frankfurt, Germany
| | - Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, USA
| | | | | | - Moshe Goldstein
- Department of Periodontology, Faculty of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Terrence J Griffin
- Periodontal Department, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Palle Holmstrup
- Periodontology, Section 1, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Georgia K Johnson
- Department of Periodontology, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Yvonne Kapila
- Orofacial Sciences, University of California San Francisco, USA
| | - Niklaus P Lang
- Department of Periodontology, University of Bern, Switzerland
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Germany
| | - Shinya Murakami
- Department of Periodontology, Graduate School of Dentistry, Osaka University, Japan
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M College of Dentistry, Dallas, TX, USA
| | - Giuseppe A Romito
- Division of Periodontology, Department of Stomatology, Dental School, University of São Paulo, Brazil
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, Ohio State University, Columbus, OH, USA
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Belgium
| | - Leonardo Trombelli
- Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Italy
| | - Clemens Walter
- Department of Periodontology, Endodontology & Cariology, University Centre for Dental Medicine, University of Basel School of Dentistry, Switzerland
| | - Gernot Wimmer
- Department of Prosthodontics, School of Dentistry, Medical University Graz, Austria
| | - Pinelopi Xenoudi
- Orofacial Sciences, School of Dentistry, University of California San Francisco, USA
| | - Hiromasa Yoshie
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Japan
| |
Collapse
|
18
|
Bartold PM, Van Dyke TE. An appraisal of the role of specific bacteria in the initial pathogenesis of periodontitis. J Clin Periodontol 2019; 46:6-11. [PMID: 30556922 DOI: 10.1111/jcpe.13046] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/13/2018] [Accepted: 12/11/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Historically, inflammatory periodontal diseases (gingivitis and periodontitis) have been recognized as being primarily of bacterial origin. Bacteria are necessary for disease development, but the presence of specific bacteria does not guarantee progression to periodontitis. Periodontitis is a multifactorial disease; specific bacteria are associated with disease, but may not be the target of treatment. Gingivitis and periodontitis are inflammatory conditions associated with bacterial overgrowth. AIM To analyse evidence for established thought that specific bacteria directly participate in the pathogenesis of periodontitis and question the long-held tenet that penetration of the periodontal connective tissues by bacteria and their products is a significant phase in the initial development of periodontitis. METHODS The literature was searched for studies on initiation of gingivitis and periodontitis by specific pathogens. The search results were insufficient for a systematic review and have been summarized in a commentary instead. RESULTS There is very little evidence in the literature to support the commonly held concept that specific bacteria initiate periodontitis. CONCLUSION We present evidence for a paradigm supporting the central role of inflammation, rather than specific microbiota, in the early pathogenesis of periodontitis, and discuss whether controlling the inflammation can influence the character and composition of the periodontal infection.
Collapse
Affiliation(s)
- Peter Mark Bartold
- School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia
| | | |
Collapse
|
19
|
Chapple IL, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, Geisinger ML, Genco RJ, Glogauer M, Goldstein M, Griffin TJ, Holmstrup P, Johnson GK, Kapila Y, Lang NP, Meyle J, Murakami S, Plemons J, Romito GA, Shapira L, Tatakis DN, Teughels W, Trombelli L, Walter C, Wimmer G, Xenoudi P, Yoshie H. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol 2018; 45 Suppl 20:S68-S77. [DOI: 10.1111/jcpe.12940] [Citation(s) in RCA: 226] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 03/11/2018] [Accepted: 03/12/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Iain L.C. Chapple
- Periodontal Research Group; Institute of Clinical Sciences; College of Medical & Dental Sciences; University of Birmingham; UK
| | - Brian L. Mealey
- University of Texas Health Science Center at San Antonio; USA
| | | | | | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry; Charité - Universitätsmedizin Berlin; Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Oral Medicine; Johann Wolfgang Goethe-University Frankfurt; Germany
| | | | | | | | - Moshe Goldstein
- Department of Periodontology; Faculty of Dental Medicine; Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Terrence J. Griffin
- Periodontal Department; Tufts University School of Dental Medicine; Boston MA USA
| | - Palle Holmstrup
- Periodontology; Section 1; Faculty of Health and Medical Sciences; University of Copenhagen; Denmark
| | - Georgia K. Johnson
- Department of Periodontology; University of Iowa College of Dentistry; Iowa City IA USA
| | - Yvonne Kapila
- Orofacial Sciences; University of California San Francisco; USA
| | - Niklaus P. Lang
- Department of Periodontology; University of Bern; Switzerland
| | - Joerg Meyle
- Department of Periodontology; University of Giessen; Germany
| | - Shinya Murakami
- Department of Periodontology; Graduate School of Dentistry, Osaka University; Japan
| | - Jacqueline Plemons
- Department of Periodontics; Texas A&M College of Dentistry; Dallas TX USA
| | - Giuseppe A. Romito
- Division of Periodontology; Department of Stomatology; Dental School; University of São Paulo; Brazil
| | - Lior Shapira
- Department of Periodontology; Faculty of Dental Medicine; Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Dimitris N. Tatakis
- Division of Periodontology; College of Dentistry; Ohio State University; Columbus OH USA
| | - Wim Teughels
- Department of Oral Health Sciences; Periodontology; KU Leuven & Dentistry; University Hospitals Leuven; Belgium
| | - Leonardo Trombelli
- Research Center for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Italy
| | - Clemens Walter
- Department of Periodontology, Endodontology & Cariology; University Centre for Dental Medicine; University of Basel School of Dentistry; Switzerland
| | - Gernot Wimmer
- Department of Prosthodontics; School of Dentistry, Medical University Graz; Austria
| | - Pinelopi Xenoudi
- Orofacial Sciences; School of Dentistry; University of California San Francisco; USA
| | - Hiromasa Yoshie
- Division of Periodontology; Niigata University Graduate School of Medical and Dental Sciences; Japan
| |
Collapse
|
20
|
Eckert M, Mizgalska D, Sculean A, Potempa J, Stavropoulos A, Eick S. In vivo expression of proteases and protease inhibitor, a serpin, by periodontal pathogens at teeth and implants. Mol Oral Microbiol 2018; 33:240-248. [PMID: 29498485 DOI: 10.1111/omi.12220] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2018] [Indexed: 12/16/2022]
Abstract
Porphyromonas gingivalis and Tannerella forsythia secrete proteases, gingipains and KLIKK-proteases. In addition, T. forsythia produces a serpin (miropin) with broad inhibitory spectrum. The aim of this pilot study was to determine the level of expression of miropin and individual proteases in vivo in periodontal and peri-implant health and disease conditions. Biofilm and gingival crevicular fluid (GCF)/ peri-implant sulcular fluid (PISF) samples were taken from healthy tooth and implant sites (n = 10), gingivitis and mucositis sites (n = 12), and periodontitis and peri-implantitis sites (n = 10). Concentration of interleukin-8 (IL-8), IL-1β and IL-10 in GCF was determined by enzyme-linked immunosorbent assay. Loads of P. gingivalis and T. forsythia and the presence of proteases and miropin genes were assessed in biofilm by quantitative PCR, whereas gene expression was estimated by quantitative RT-PCR. The presence of P. gingivalis and T. forsythia, as well as the level of IL-8 and IL-1β, were associated with disease severity in the periodontal and peri-implant tissues. In biofilm samples harboring T. forsythia, genes encoding proteases were found to be present at 72.4% for karilysin and 100% for other KLIKK-protease genes and miropin. At the same time, detectable mRNA expression of individual genes ranged from 20.7% to 58.6% of samples (for forsylisin and miropsin-1, respectively). In comparison with the T. forsythia proteases, miropin and the gingipains were highly expressed. The level of expression of gingipains was associated with those of miropin and certain T. forsythia proteases around teeth but not implants. Cumulatively, KLIKK-proteases and especially miropin, might play a role in pathogenesis of both periodontal and peri-implant diseases.
Collapse
Affiliation(s)
- M Eckert
- Department of Periodontology, University of Bern, School of Dental Medicine, Bern, Switzerland
| | - D Mizgalska
- Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, Krakow, Poland
| | - A Sculean
- Department of Periodontology, University of Bern, School of Dental Medicine, Bern, Switzerland
| | - J Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, Krakow, Poland.,Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, USA
| | - A Stavropoulos
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - S Eick
- Department of Periodontology, University of Bern, School of Dental Medicine, Bern, Switzerland
| |
Collapse
|
21
|
Abstract
The last few decades have witnessed an increasing interest in studying the human microbiome and its role in health and disease. The focus of those studies was mainly the characterization of changes in the composition of the microbial communities under different conditions. As a result of those studies, we now know that imbalance in the composition of the microbiome, also referred to as microbial dysbiosis, is directly linked to developing certain conditions. Dysbiosis of the oral microbiome is a prime example of how this imbalance leads to disease in the case of periodontal disease. However, there is considerable overlap in the phylogenetic profiles of microbial communities associated with active and inactive lesions, suggesting that the difference in periodontal status of those sites may not be explained solely by differences in the subgingival microbial composition. These findings suggest that differences in functional activities may be the essential elements that define the dysbiotic process. Researchers have recently begun to study gene expression of the oral microbiome in situ with the goal of identifying changes in functional activities that could explain the transition from health to disease. These initial results suggest that, rather than a specific composition, a better understanding of oral dysbiosis can be obtained from the study of functional activities of the microbial community. In this review, we give a summary of these initial studies, which have opened a new door to our understanding of the dynamics of the oral community during the dysbiotic process in the oral cavity.
Collapse
Affiliation(s)
- J Solbiati
- 1 Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - J Frias-Lopez
- 1 Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
| |
Collapse
|
22
|
Bartold PM, Van Dyke TE. Host modulation: controlling the inflammation to control the infection. Periodontol 2000 2017; 75:317-329. [DOI: 10.1111/prd.12169] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
23
|
McCracken G, Asuni A, Ritchie M, Vernazza C, Heasman P. Failing to meet the goals of periodontal recall programs. What next? Periodontol 2000 2017; 75:330-352. [DOI: 10.1111/prd.12159] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
24
|
Van Dyke TE. Pro-resolving mediators in the regulation of periodontal disease. Mol Aspects Med 2017; 58:21-36. [PMID: 28483532 DOI: 10.1016/j.mam.2017.04.006] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/11/2017] [Accepted: 04/12/2017] [Indexed: 01/07/2023]
Abstract
Periodontitis is an inflammatory disease of the supporting structures of the dentition that is initiated by bacteria that form a biofilm on the surface of the teeth. The pathogenesis of the disease is a result of complex interactions between the biofilm and the host response that results in dysbiosis of the microbiome and dysregulation of the inflammatory response. Current data suggest that the excess inflammation associated with periodontitis is due to a failure of resolution of inflammation pathways. In this review, the relationship between inflammation and microbial dysbiosis is examined in the context of pro-inflammation and pro-resolution mediators and their ability to modify the course of disease. The impact of local oral inflammation on systemic inflammation and the relationship of periodontitis to other inflammatory diseases, including type 2 diabetes and cardiovascular disease is reviewed. Active resolvers of inflammation, including the lipoxins and resolvins, show great promise as therapeutics for the treatment of periodontitis and other inflammatory diseases.
Collapse
|
25
|
Damgaard C, Kantarci A, Holmstrup P, Hasturk H, Nielsen CH, Van Dyke TE. Porphyromonas gingivalis-induced production of reactive oxygen species, tumor necrosis factor-α, interleukin-6, CXCL8 and CCL2 by neutrophils from localized aggressive periodontitis and healthy donors: modulating actions of red blood cells and resolvin E1. J Periodontal Res 2017; 52:246-254. [PMID: 27146665 PMCID: PMC5097708 DOI: 10.1111/jre.12388] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Porphyromonas gingivalis is regarded as a significant contributor in the pathogenesis of periodontitis and certain systemic diseases, including atherosclerosis. P. gingivalis occasionally translocates from periodontal pockets into the circulation, where it adheres to red blood cells (RBCs). This may protect the bacterium from contact with circulating phagocytes without affecting its viability. MATERIAL AND METHODS In this in vitro study, we investigated whether human peripheral blood neutrophils from 10 subjects with localized aggressive periodontitis (LAgP) and 10 healthy controls release the proinflammatory cytokines interleukin (IL)-6, tumor necrosis factor α (TNF-α), the chemokine (C-X-C motif) ligand 8 (CXCL8; also known as IL-8) and chemokine (C-C motif) ligand 2 (CCL2; also known as monocyte chemotactic protein-1) and intracellular reactive oxygen species (ROS) in response to challenge with P. gingivalis. In addition, the impact of RBC interaction with P. gingivalis was investigated. The actions of resolvin E1 (RvE1), a known regulator of P. gingivalis induced neutrophil responses, on the cytokine and ROS responses elicited by P. gingivalis in cultures of neutrophils were investigated. RESULTS Upon stimulation with P. gingivalis, neutrophils from subjects with LAgP and healthy controls released similar quantities of IL-6, TNF-α, CXCL8, CCL2 and intracellular ROS. The presence of RBCs amplified the release of IL-6, TNF-α and CCL2 statistically significant in both groups, but reduced the generation of ROS in the group of healthy controls, and showed a similar tendency in the group of subjects with LAgP. RvE1 had no impact on the production of intracellular ROS, TNF-α, IL-6, CXCL8 and CCL2 by neutrophils from either group, but tended to reduce the generation of ROS in subjects with LAgP in the absence of RBCs. CONCLUSIONS Our data support that binding to RBCs protects P. gingivalis from ROS and concomitantly enhances neutrophil release of proinflammatory cytokines providing a selective advantage for P. gingivalis growth.
Collapse
Affiliation(s)
- Christian Damgaard
- Section for Periodontology, Microbiology and Community
Dentistry, Department of Odontology, Faculty of Health and Medical Sciences,
University of Copenhagen, Copenhagen, Denmark
- Institute for Inflammation Research, Center for
Rheumatology and Spine Disease, Rigshospitalet, Copenhagen University Hospital,
Copenhagen, Denmark
- Department of Applied Oral Sciences, Center for
Periodontology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Alpdogan Kantarci
- Department of Applied Oral Sciences, Center for
Periodontology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Palle Holmstrup
- Section for Periodontology, Microbiology and Community
Dentistry, Department of Odontology, Faculty of Health and Medical Sciences,
University of Copenhagen, Copenhagen, Denmark
| | - Hatice Hasturk
- Department of Applied Oral Sciences, Center for
Periodontology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Claus H. Nielsen
- Section for Periodontology, Microbiology and Community
Dentistry, Department of Odontology, Faculty of Health and Medical Sciences,
University of Copenhagen, Copenhagen, Denmark
- Institute for Inflammation Research, Center for
Rheumatology and Spine Disease, Rigshospitalet, Copenhagen University Hospital,
Copenhagen, Denmark
| | - Thomas E. Van Dyke
- Department of Applied Oral Sciences, Center for
Periodontology, The Forsyth Institute, Cambridge, Massachusetts, USA
| |
Collapse
|
26
|
Rams TE, van Winkelhoff AJ. Introduction to Clinical Microbiology for the General Dentist. Dent Clin North Am 2017; 61:179-197. [PMID: 28317561 DOI: 10.1016/j.cden.2016.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Clinical oral microbiology may help dental professionals identify infecting pathogenic species and evaluate their in vitro antimicrobial susceptibility. Saliva, dental plaque biofilms, mucosal smears, abscess aspirates, and soft tissue biopsies are sources of microorganisms for laboratory testing. Microbial-based treatment end points may help clinicians better identify patients in need of additional or altered dental therapies before the onset of clinical treatment failure, and help improve patient oral health outcomes. Microbiological testing appears particularly helpful in periodontal disease treatment planning. Further research and technological advances are likely to increase the availability and clinical utility of microbiological analysis in modern dental practice.
Collapse
Affiliation(s)
- Thomas E Rams
- Department of Periodontology and Oral Implantology, Oral Microbiology Testing Service Laboratory, Temple University School of Dentistry, 3223 North Broad Street, Philadelphia, PA 19140, USA; Department of Microbiology and Immunology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA 19140, USA.
| | - Arie J van Winkelhoff
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, Faculty of Medical Sciences, University of Groningen, Antonius Deusinglaan 1, Groningen 9713 AV, The Netherlands; Department of Medical Microbiology, University Medical Center Groningen, Faculty of Medical Sciences, University of Groningen, Hanzeplein 1, Groningen GZ 9713, The Netherlands
| |
Collapse
|
27
|
Lee CT, Teles R, Kantarci A, Chen T, McCafferty J, Starr JR, Brito LCN, Paster BJ, Van Dyke TE. Resolvin E1 Reverses Experimental Periodontitis and Dysbiosis. THE JOURNAL OF IMMUNOLOGY 2016; 197:2796-806. [PMID: 27543615 DOI: 10.4049/jimmunol.1600859] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 07/23/2016] [Indexed: 12/14/2022]
Abstract
Periodontitis is a biofilm-induced inflammatory disease characterized by dysbiosis of the commensal periodontal microbiota. It is unclear how natural regulation of inflammation affects the periodontal biofilm. Promoters of active resolution of inflammation, including resolvin E1 (RvE1), effectively treat inflammatory periodontitis in animal models. The goals of this study were 1) to compare periodontal tissue gene expression in different clinical conditions, 2) to determine the impact of local inflammation on the composition of subgingival bacteria, and 3) to understand how inflammation impacts these changes. Two clinically relevant experiments were performed in rats: prevention and treatment of ligature-induced periodontitis with RvE1 topical treatment. The gingival transcriptome was evaluated by RNA sequencing of mRNA. The composition of the subgingival microbiota was characterized by 16S rDNA sequencing. Periodontitis was assessed by bone morphometric measurements and histomorphometry of block sections. H&E and tartrate-resistant acid phosphatase staining were used to characterize and quantify inflammatory changes. RvE1 treatment prevented bone loss in ligature-induced periodontitis. Osteoclast density and inflammatory cell infiltration in the RvE1 groups were lower than those in the placebo group. RvE1 treatment reduced expression of inflammation-related genes, returning the expression profile to one more similar to health. Treatment of established periodontitis with RvE1 reversed bone loss, reversed inflammatory gene expression, and reduced osteoclast density. Assessment of the rat subgingival microbiota after RvE1 treatment revealed marked changes in both prevention and treatment experiments. The data suggest that modulation of local inflammation has a major role in shaping the composition of the subgingival microbiota.
Collapse
Affiliation(s)
- Chun-Teh Lee
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142; and
| | - Ricardo Teles
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142; and
| | - Alpdogan Kantarci
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142; and
| | - Tsute Chen
- Department of Microbiology, The Forsyth Institute, Cambridge, MA 02142
| | - Jon McCafferty
- Department of Microbiology, The Forsyth Institute, Cambridge, MA 02142
| | - Jacqueline R Starr
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142; and
| | | | - Bruce J Paster
- Department of Microbiology, The Forsyth Institute, Cambridge, MA 02142
| | - Thomas E Van Dyke
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142; and
| |
Collapse
|
28
|
Chee B, Park B, Fitzsimmons T, Coates AM, Bartold PM. Omega-3 fatty acids as an adjunct for periodontal therapy-a review. Clin Oral Investig 2016; 20:879-94. [PMID: 26885664 DOI: 10.1007/s00784-016-1750-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/10/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this article is to present an overview of omega-3 fatty acids, their anti-inflammatory properties and potential use as an adjunct for periodontal therapy. MATERIALS AND METHODS A general literature search was conducted to provide an overview of omega-3 fatty acids, their metabolism and anti-inflammatory properties. A more specific literature search of PubMed and EMBASE was conducted to identify articles dealing studies investigating the effects of omega-3 fatty acids in the treatment of periodontitis in animals and humans and included cross-sectional, longitudinal and intervention designs. RESULTS To date, there is good emerging evidence that dietary supplementation with fish oil may be of some benefit and this is enhanced if combined with aspirin. All clinical intervention studies to date have been on small sample sizes, and this indicates there is need for larger and more robust clinical trials to verify these initial findings. CONCLUSIONS Dietary supplementation with fish oil could be a cost-effective adjunctive therapy to the management of periodontal disease. CLINICAL RELEVANCE The host modulatory properties of omega-3 fatty acids warrant further assessment of their use as an adjunct in the management of periodontitis.
Collapse
Affiliation(s)
- B Chee
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - B Park
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - T Fitzsimmons
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - A M Coates
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - P M Bartold
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia.
| |
Collapse
|
29
|
Oral biosciences: The annual review 2015. J Oral Biosci 2016. [DOI: 10.1016/j.job.2015.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
30
|
Abstract
BACKGROUND Anaerobic culture has been critical in our understanding of the oral microbiotas. HIGHLIGHT Studies in advanced periodontitis in the 1970's revealed microbial complexes that associated with different clinical presentations. Taxonomy studies identified species newly-observed in periodontitis as Aggregatibacter (Actinobacillus) actinomycetemcomitans, Campylobacter (Wolinella) rectus and other Campylobacter species, and Tannerella (Bacteroides) forsythia. Anaerobic culture of initial periodontitis showed overlap in the microbiota with gingivitis, and added Selenomonas noxia and Filifactor alocis as putative periodontal pathogens. Porphyromonas gingivalis and T. forsythia were found to be associated with initial periodontitis in adults. The dominant microbiota of dental caries differs from that of periodontitis. The major cariogenic species are acidogenic and acid tolerant species particularly Streptococcus mutans, and Lactobacillus and Bifidobacterium species. Anaerobic culture of severe early childhood caries revealed a widely diverse microbiota, comparable to that observed using cloning and sequencing. The PCR-based cloning approach, however, underestimated Actinobacteria compared with culture. Only a subset of the caries-associated microbiota was acid tolerant, with different segments of the microbiota cultured on blood agar compared to a low pH acid agar. While the major caries-associated species was S. mutans, a new species, Scardovia wiggsiae, was significantly associated with early childhood caries. Higher counts of S. wiggsiae were also observed in initial white spot carious lesions in adolescents. CONCLUSION In periodontitis and dental caries, anaerobic culture studies of advanced disease provided a comprehensive analysis of the microbiota of these infections. Anaerobic culture highlighted the limitation of PCR with standard primers that underestimate detection of Actinobacteria.
Collapse
Affiliation(s)
- Anne C R Tanner
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts 02142, USA ; Department of Oral Medicine, Infection and Immunity, Harvard School Dental Medicine, Boston MA 02115, USA
| |
Collapse
|
31
|
Hajishengallis G. The inflammophilic character of the periodontitis-associated microbiota. Mol Oral Microbiol 2014; 29:248-57. [PMID: 24976068 DOI: 10.1111/omi.12065] [Citation(s) in RCA: 263] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2014] [Indexed: 01/05/2023]
Abstract
In periodontitis, dysbiotic microbial communities exhibit synergistic interactions for enhanced protection from host defenses, nutrient acquisition, and persistence in an inflammatory environment. This review discusses evidence that periodontitis-associated communities are 'inflammo-philic' (=loving or attracted to inflammation) in that they have evolved to not only endure inflammation but also to take advantage of it. In this regard, inflammation can drive the selection and enrichment of these pathogenic communities by providing a source of nutrients in the form of tissue breakdown products (e.g. degraded collagen peptides and heme-containing compounds). In contrast, those species that cannot benefit from the altered ecological conditions of the inflammatory environment, or for which host inflammation is detrimental, are likely to be outcompeted. Consistent with the concept that inflammation fosters the growth of dysbiotic microbial communities, the bacterial biomass of human periodontitis-associated biofilms was shown to increase with increasing periodontal inflammation. Conversely, anti-inflammatory treatments in animal models of periodontitis were shown to diminish the periodontal bacterial load, in addition to protecting from bone loss. The selective flourishing of inflammophilic bacteria can perpetuate inflammatory tissue destruction by setting off a 'vicious cycle' for disease progression, in which dysbiosis and inflammation reinforce each other. Therefore, the control of inflammation appears to be central to the treatment of periodontitis, as it is likely to control both dysbiosis and disease progression.
Collapse
Affiliation(s)
- G Hajishengallis
- Department of Microbiology, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| |
Collapse
|
32
|
Teles R, Teles F, Frias-Lopez J, Paster B, Haffajee A. Lessons learned and unlearned in periodontal microbiology. Periodontol 2000 2014; 62:95-162. [PMID: 23574465 PMCID: PMC3912758 DOI: 10.1111/prd.12010] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Periodontal diseases are initiated by bacterial species living in polymicrobial biofilms at or below the gingival margin and progress largely as a result of the inflammation elicited by specific subgingival species. In the past few decades, efforts to understand the periodontal microbiota have led to an exponential increase in information about biofilms associated with periodontal health and disease. In fact, the oral microbiota is one of the best-characterized microbiomes that colonize the human body. Despite this increased knowledge, one has to ask if our fundamental concepts of the etiology and pathogenesis of periodontal diseases have really changed. In this article we will review how our comprehension of the structure and function of the subgingival microbiota has evolved over the years in search of lessons learned and unlearned in periodontal microbiology. More specifically, this review focuses on: (i) how the data obtained through molecular techniques have impacted our knowledge of the etiology of periodontal infections; (ii) the potential role of viruses in the etiopathogenesis of periodontal diseases; (iii) how concepts of microbial ecology have expanded our understanding of host-microbe interactions that might lead to periodontal diseases; (iv) the role of inflammation in the pathogenesis of periodontal diseases; and (v) the impact of these evolving concepts on therapeutic and preventive strategies to periodontal infections. We will conclude by reviewing how novel systems-biology approaches promise to unravel new details of the pathogenesis of periodontal diseases and hopefully lead to a better understanding of their mechanisms.
Collapse
|
33
|
Li Y, He J, He Z, Zhou Y, Yuan M, Xu X, Sun F, Liu C, Li J, Xie W, Deng Y, Qin Y, VanNostrand JD, Xiao L, Wu L, Zhou J, Shi W, Zhou X. Phylogenetic and functional gene structure shifts of the oral microbiomes in periodontitis patients. ISME JOURNAL 2014; 8:1879-91. [PMID: 24671083 DOI: 10.1038/ismej.2014.28] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 12/09/2013] [Accepted: 01/25/2014] [Indexed: 02/05/2023]
Abstract
Determining the composition and function of subgingival dental plaque is crucial to understanding human periodontal health and disease, but it is challenging because of the complexity of the interactions between human microbiomes and human body. Here, we examined the phylogenetic and functional gene differences between periodontal and healthy individuals using MiSeq sequencing of 16S rRNA gene amplicons and a specific functional gene array (a combination of GeoChip 4.0 for biogeochemical processes and HuMiChip 1.0 for human microbiomes). Our analyses indicated that the phylogenetic and functional gene structure of the oral microbiomes were distinctly different between periodontal and healthy groups. Also, 16S rRNA gene sequencing analysis indicated that 39 genera were significantly different between healthy and periodontitis groups, and Fusobacterium, Porphyromonas, Treponema, Filifactor, Eubacterium, Tannerella, Hallella, Parvimonas, Peptostreptococcus and Catonella showed higher relative abundances in the periodontitis group. In addition, functional gene array data showed that a lower gene number but higher signal intensity of major genes existed in periodontitis, and a variety of genes involved in virulence factors, amino acid metabolism and glycosaminoglycan and pyrimidine degradation were enriched in periodontitis, suggesting their potential importance in periodontal pathogenesis. However, the genes involved in amino acid synthesis and pyrimidine synthesis exhibited a significantly lower relative abundance compared with healthy group. Overall, this study provides new insights into our understanding of phylogenetic and functional gene structure of subgingival microbial communities of periodontal patients and their importance in pathogenesis of periodontitis.
Collapse
Affiliation(s)
- Yan Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jinzhi He
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhili He
- Institute for Environmental Genomics, Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, USA
| | - Yuan Zhou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mengting Yuan
- Institute for Environmental Genomics, Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, USA
| | - Xin Xu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Feifei Sun
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chengcheng Liu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenbo Xie
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ye Deng
- Institute for Environmental Genomics, Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, USA
| | - Yujia Qin
- Institute for Environmental Genomics, Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, USA
| | - Joy D VanNostrand
- Institute for Environmental Genomics, Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, USA
| | - Liying Xiao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liyou Wu
- Institute for Environmental Genomics, Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, USA
| | - Jizhong Zhou
- Institute for Environmental Genomics, Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, USA
| | - Wenyuan Shi
- 1] State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China [2] UCLA School of Dentistry, Los Angeles, CA, USA
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| |
Collapse
|
34
|
Tu Q, He Z, Li Y, Chen Y, Deng Y, Lin L, Hemme CL, Yuan T, Van Nostrand JD, Wu L, Zhou X, Shi W, Li L, Xu J, Zhou J. Development of HuMiChip for functional profiling of human microbiomes. PLoS One 2014; 9:e90546. [PMID: 24595026 PMCID: PMC3942451 DOI: 10.1371/journal.pone.0090546] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 02/01/2014] [Indexed: 02/05/2023] Open
Abstract
Understanding the diversity, composition, structure, function, and dynamics of human microbiomes in individual human hosts is crucial to reveal human-microbial interactions, especially for patients with microbially mediated disorders, but challenging due to the high diversity of the human microbiome. Here we have developed a functional gene-based microarray for profiling human microbiomes (HuMiChip) with 36,802 probes targeting 50,007 protein coding sequences for 139 key functional gene families. Computational evaluation suggested all probes included are highly specific to their target sequences. HuMiChip was used to analyze human oral and gut microbiomes, showing significantly different functional gene profiles between oral and gut microbiome. Obvious shifts of microbial functional structure and composition were observed for both patients with dental caries and periodontitis from moderate to advanced stages, suggesting a progressive change of microbial communities in response to the diseases. Consistent gene family profiles were observed by both HuMiChip and next generation sequencing technologies. Additionally, HuMiChip was able to detect gene families at as low as 0.001% relative abundance. The results indicate that the developed HuMiChip is a useful and effective tool for functional profiling of human microbiomes.
Collapse
Affiliation(s)
- Qichao Tu
- Department of Microbiology and Plant Biology, Institute for Environmental Genomics, University of Oklahoma, Norman, Oklahoma, United States of America
| | - Zhili He
- Department of Microbiology and Plant Biology, Institute for Environmental Genomics, University of Oklahoma, Norman, Oklahoma, United States of America
| | - Yan Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yanfei Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Ye Deng
- Department of Microbiology and Plant Biology, Institute for Environmental Genomics, University of Oklahoma, Norman, Oklahoma, United States of America
| | - Lu Lin
- Chinese Academy of Sciences, Qingdao Institute of Bioenergy and Bioprocess Technology, Qingdao, Shandong, China
| | - Christopher L. Hemme
- Department of Microbiology and Plant Biology, Institute for Environmental Genomics, University of Oklahoma, Norman, Oklahoma, United States of America
| | - Tong Yuan
- Department of Microbiology and Plant Biology, Institute for Environmental Genomics, University of Oklahoma, Norman, Oklahoma, United States of America
| | - Joy D. Van Nostrand
- Department of Microbiology and Plant Biology, Institute for Environmental Genomics, University of Oklahoma, Norman, Oklahoma, United States of America
| | - Liyou Wu
- Department of Microbiology and Plant Biology, Institute for Environmental Genomics, University of Oklahoma, Norman, Oklahoma, United States of America
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenyuan Shi
- UCLA School of Dentistry, University of California Los Angeles, Los Angeles, California, United States of America
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Jian Xu
- Chinese Academy of Sciences, Qingdao Institute of Bioenergy and Bioprocess Technology, Qingdao, Shandong, China
| | - Jizhong Zhou
- Department of Microbiology and Plant Biology, Institute for Environmental Genomics, University of Oklahoma, Norman, Oklahoma, United States of America
- Earth Science Division, Lawrence Berkeley National Laboratory, Berkeley, California, United States of America
- State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, China
| |
Collapse
|
35
|
Shet UK, Oh HK, Kim HJ, Chung HJ, Kim YJ, Kim OS, Choi HR, Kim OJ, Lim HJ, Lee SW. Quantitative analysis of periodontal pathogens present in the saliva of geriatric subjects. J Periodontal Implant Sci 2013; 43:183-90. [PMID: 24040571 PMCID: PMC3769597 DOI: 10.5051/jpis.2013.43.4.183] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 08/07/2013] [Indexed: 11/08/2022] Open
Abstract
PURPOSE At present, information regarding periodontal disease in geriatric patients is scarce. The purpose of this study was to quantify the periodontal pathogens present in the saliva of Korean geriatric patients and assess the relationship between the bacterial levels and the periodontal condition. METHODS Six putative periodontal pathogens were quantified by using a real-time polymerase chain reaction assay in geriatric patient groups (>60 years) with mild chronic periodontitis (MCP), moderate chronic periodontitis (MoCP), and severe chronic periodontitis (SCP). The copy numbers of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Prevotella intermedia were measured. RESULTS It was found that the bacterial copy numbers increased as the severity of the disease increased from MCP to SCP, except for P. intermedia. For P. intermedia, it was found that samples in the MCP group yielded the largest amount. It was also found that the quantities of P. gingivalis, T. forsythia, and T. denticola, the so-called "red complex" bacteria, were lower than those of F. nucleatum, A. actinomycetemcomitans, and P. intermedia in all of the samples. CONCLUSIONS Collectively, the results of this study suggest that the levels of P. gingivalis, T. forsythia, F. nucleatum, and T. denticola present in saliva are associated with the severity of periodontal disease in geriatric patients.
Collapse
Affiliation(s)
- Uttom K Shet
- Department of Oral & Maxillofacial Surgery, Dental Science Research Institute, Chonnam National University School of Dentistry, Gwangju, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Abusleme L, Dupuy AK, Dutzan N, Silva N, Burleson JA, Strausbaugh LD, Gamonal J, Diaz PI. The subgingival microbiome in health and periodontitis and its relationship with community biomass and inflammation. THE ISME JOURNAL 2013; 7:1016-25. [PMID: 23303375 PMCID: PMC3635234 DOI: 10.1038/ismej.2012.174] [Citation(s) in RCA: 664] [Impact Index Per Article: 60.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 11/16/2012] [Accepted: 12/06/2012] [Indexed: 01/22/2023]
Abstract
The goals of this study were to better understand the ecology of oral subgingival communities in health and periodontitis and elucidate the relationship between inflammation and the subgingival microbiome. Accordingly, we used 454-pyrosequencing of 16S rRNA gene libraries and quantitative PCR to characterize the subgingival microbiome of 22 subjects with chronic periodontitis. Each subject was sampled at two sites with similar periodontal destruction but differing in the presence of bleeding, a clinical indicator of increased inflammation. Communities in periodontitis were also compared with those from 10 healthy individuals. In periodontitis, presence of bleeding was not associated with different α-diversity or with a distinct microbiome, however, bleeding sites showed higher total bacterial load. In contrast, communities in health and periodontitis largely differed, with higher diversity and biomass in periodontitis. Shifts in community structure from health to periodontitis resembled ecological succession, with emergence of newly dominant taxa in periodontitis without replacement of primary health-associated species. That is, periodontitis communities had higher proportions of Spirochetes, Synergistetes, Firmicutes and Chloroflexi, among other taxa, while the proportions of Actinobacteria, particularly Actinomyces, were higher in health. Total Actinomyces load, however, remained constant from health to periodontitis. Moreover, an association existed between biomass and community structure in periodontitis, with the proportion of specific taxa correlating with bacterial load. Our study provides a global-scale framework for the ecological events in subgingival communities that underline the development of periodontitis. The association, in periodontitis, between inflammation, community biomass and community structure and their role in disease progression warrant further investigation.
Collapse
Affiliation(s)
- Loreto Abusleme
- Division of Periodontology, Department of Oral Health and Diagnostic Sciences, The University of Connecticut Health Center, Farmington, CT, USA
- Laboratory of Oral Microbiology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Amanda K Dupuy
- Center for Applied Genetics and Technologies, The University of Connecticut, Storrs, CT, USA
| | - Nicolás Dutzan
- Laboratory of Periodontal Biology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Nora Silva
- Laboratory of Oral Microbiology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Joseph A Burleson
- Division of Epidemiology and Biostatistics, Department of Community Medicine and Health Care, The University of Connecticut Health Center, Farmington, CT, USA
| | - Linda D Strausbaugh
- Center for Applied Genetics and Technologies, The University of Connecticut, Storrs, CT, USA
| | - Jorge Gamonal
- Laboratory of Periodontal Biology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Patricia I Diaz
- Division of Periodontology, Department of Oral Health and Diagnostic Sciences, The University of Connecticut Health Center, Farmington, CT, USA
| |
Collapse
|
37
|
Abstract
OBJECTIVES Little is known about the effect of diet on the oral microbiota of infants, although diet is known to affect the gut microbiota. The aims of the present study were to compare the oral microbiota in breast-fed and formula-fed infants, and investigate growth inhibition of streptococci by infant-isolated lactobacilli. METHODS A total of 207 mothers consented to participation of their 3-month-old infants. A total of 146 (70.5%) infants were exclusively and 38 (18.4%) partially breast-fed, and 23 (11.1%) were exclusively formula-fed. Saliva from all of their infants was cultured for Lactobacillus species, with isolate identifications from 21 infants. Lactobacillus isolates were tested for their ability to suppress Streptococcus mutans and S sanguinis. Oral swabs from 73 infants were analysed by the Human Oral Microbe Identification Microarray (HOMIM) and by quantitative polymerase chain reaction for Lactobacillus gasseri. RESULTS Lactobacilli were cultured from 27.8% of exclusively and partially breast-fed infants, but not from formula-fed infants. The prevalence of 14 HOMIM-detected taxa, and total salivary lactobacilli counts differed by feeding method. Multivariate modelling of HOMIM-detected bacteria and possible confounders clustered samples from breast-fed infants separately from formula-fed infants. The microbiota of breast-fed infants differed based on vaginal or C-section delivery. Isolates of L plantarum, L gasseri, and L vaginalis inhibited growth of the cariogenic S mutans and the commensal S sanguinis: L plantarum >L gasseri >L vaginalis. CONCLUSIONS The microbiota of the mouth differs between 3-month-old breast-fed and formula-fed infants. Possible mechanisms for microbial differences observed include species suppression by lactobacilli indigenous to breast milk.
Collapse
|
38
|
Nguyen-Hieu T. Microbial sampling process can change results of microbiological analysis in periodontitis diagnosis. A minireview. ACTA ACUST UNITED AC 2012. [PMID: 23188761 DOI: 10.1111/jicd.12010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This minireview aims to verify the supposition that the microbial sampling process can change results of microbiological analysis in periodontitis diagnosis. The literature search via Pubmed yielded 52 appropriate articles for analysis. Of which 38% (20/52) described that the sampling sites were isolated from saliva, whereas 62% (32/52) did not. Also, 29% (15/52) declared that the microbial sampling was performed before probing pocket depth (PPD), whereas 71% (37/52) did not. Comparison of the results of microbiological analysis in these studies showed that the bacteria most frequently detected in periodontal pockets was variable. Therefore, a sampling process that includes both the microbial sample being taken before PPD and saliva isolation of the sampling sites is needed to ensure the accuracy of microbiological analysis in periodontitis diagnosis.
Collapse
Affiliation(s)
- Tung Nguyen-Hieu
- Aix-Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, Marseille, France.
| |
Collapse
|
39
|
Benrachadi L, Bouziane A, Azziman Z, Bouziane-Ouartini F, Ennibi O. Screening for periodontopathogenic bacteria in severe chronic periodontitis in a Moroccan population. Med Mal Infect 2012; 42:599-602. [PMID: 23141872 DOI: 10.1016/j.medmal.2012.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 07/29/2012] [Accepted: 10/03/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Bacteria play an important role in destructive periodontitis. The aim of this study was to screen for five highly pathogenic bacteria: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola, in Moroccan patients presenting with severe chronic periodontitis and to compare results with those of patients presenting with severe aggressive periodontitis. MATERIALS AND METHODS Twenty-three patients were included at the periodontology unit (School of dental medicine, University Mohammed 5 Souissi, Rabat, Morocco). The study was made on two groups: a test group of patients presenting with severe chronic periodontitis, and a control group of patients presenting with severe aggressive periodontitis. Plaque sampling was performed at the four deepest sites in each patient. The five studied bacteria were detected by PCR. RESULTS The prevalence of A. actinomycetemcomitans and T. denticola was relatively low in the test group (13.3% and 20% respectively) compared with controls (37.5% and 37.5% respectively), without any statistical difference between the two groups. Furthermore, P. gingivalis and T. forsythia were frequently detected in both groups, without any statistical difference. CONCLUSION The results of this preliminary study proved the presence of the studied periodontopathogenic bacteria both in severe chronic periodontitis and severe aggressive periodontitis.
Collapse
Affiliation(s)
- L Benrachadi
- Service de Parodontologie, Faculté de Médecine Dentaire de Rabat, Université Mohammed V Souissi, BP 6212 Rabat - les Instituts, Rabat, Morocco.
| | | | | | | | | |
Collapse
|
40
|
Zhang SM, Tian F, Huang QF, Zhao YF, Guo XK, Zhang FQ. Bacterial diversity of subgingival plaque in 6 healthy Chinese individuals. Exp Ther Med 2011; 2:1023-1029. [PMID: 22977615 DOI: 10.3892/etm.2011.311] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 06/29/2011] [Indexed: 01/05/2023] Open
Abstract
The subgingival microbial ecology is complex, and little is known regarding its bacteria species composition in healthy Chinese individuals. This study aimed to identify the subgingival microbiota from 6 healthy Chinese subjects. Subgingival samples from 6 volunteers were collected, the 16S rRNA gene was amplified using broad-range bacterial primers, and clone libraries were constructed. For the initial 2,439 sequences analyzed, 383 species-level operational taxonomic units (SLOTUs) belonging to seven phyla were identified, estimated as 51% [95% confidence interval (CI) 44-55] of the SLOTUs in this ecosystem. Most (85%) of the bacterial sequences, falling into 228 types of species, corresponded to known and cultivated species. However, 146 (6%) sequences, comprising 104 phylotypes, had <97% similarity to prior database sequences. Ten bacterial genera were conserved among all 6 individuals, comprising 2,000 (82%) of the 2,439 clones analyzed. Ten species were noted in all of the 6 subjects, comprising 1,435 (58.8%) of the 2,439 clones. Streptococcus infantis was the species most frequently cloned. Furthermore, certain species which may participate in the pathogenesis of periodontal disease were present in the 6 subjects. Although the initial subgingival plaque community of each subject was unique in terms of diversity and composition, 10 common key species were found in the 6 Chinese individuals. These ten species of bacteria in the human subgingival plaque in the 6 healthy individuals may be key species which, to some extent, affect periodontal health. Destruction of these key species in subgingival bacteria may break the microbiota balance and may easily lead to over-breeding conditions resulting in pathogenic oral disease.
Collapse
Affiliation(s)
- Song-Mei Zhang
- Department of Prosthodontics, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011
| | | | | | | | | | | |
Collapse
|
41
|
Van Dyke TE. Proresolving lipid mediators: potential for prevention and treatment of periodontitis. J Clin Periodontol 2011; 38 Suppl 11:119-25. [PMID: 21323709 DOI: 10.1111/j.1600-051x.2010.01662.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIM Periodontitis is an inflammatory disease initiated by microbial biofilm. The host response to the biofilm destroys the periodontium mediated by an overly robust inflammatory response in susceptible individuals. Whether the excessive host response is genetic, epigenetic or mediated by environment is unknown. New pathways of resolution of inflammation have been discovered. Resolution of inflammation is an active, agonist-mediated, programmed return to tissue homeostasis. MATERIALS AND METHODS Various computer-based search engines were employed to identify papers relevant to resolution of inflammation. RESULTS Recent data suggest that chronic inflammatory periodontal disease may be a failure of resolution pathways as well as overexpression of proinflammatory pathways. In this review, the biology of resolution of inflammation will be examined in normal tissues and periodontal disease. Anti-inflammatory pharmacologic agents [non-steroidal anti-inflammatory drugs (NSAIDs)] have been shown to prevent and slow the progression of periodontitis in animals and humans. However, the side effect profile of NSAIDS or other inhibitors or receptor antagonists preclude their use in periodontal therapy. CONCLUSION The isolation and characterization of proresolving lipid mediators that are receptor agonists has opened a new area of research for potential therapeutic agents for the management of inflammatory periodontitis.
Collapse
Affiliation(s)
- Thomas E Van Dyke
- Department of Periodontology and Oral Biology, Boston University, Boston, MA, USA.
| |
Collapse
|
42
|
Tonetti MS, Chapple ILC. Biological approaches to the development of novel periodontal therapies--consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol 2011; 38 Suppl 11:114-8. [PMID: 21323708 DOI: 10.1111/j.1600-051x.2010.01675.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Periodontitis remains a major public health issue and current management approaches have failed to impact upon the most high-risk proportion of the population and those with the most severe disease. The objective of this session was to assess if and how, current understanding of periodontitis provides the opportunity to develop new preventive and therapeutic strategies. MATERIALS AND METHODS Based on the current understanding of the pathophysiology of periodontal diseases, the Workshop discussed the potential of antimicrobial peptides, probiotics, pro-resolving lipid mediators, and micronutritional approaches. Evidence-based position papers and expert discussions formed the basis of deliberations. RESULTS AND DISCUSSION Current preventive and treatment approaches are only partially effective, and this appears due to the therapeutic focus remaining primarily upon biofilm management rather than embracing a pivotal role for inflammation as a driver of biofilm composition as well as tissue damage. There is a need to develop new, more effective, and efficient preventive and treatment approaches for gingivitis and periodontitis, which embrace recent advances in understanding of host modulation and inflammation resolution, as well as direct management of the microbiota.
Collapse
|
43
|
Stashenko P, Van Dyke T, Tully P, Kent R, Sonis S, Tanner ACR. Inflammation and genetic risk indicators for early periodontitis in adults. J Periodontol 2010; 82:588-96. [PMID: 21054222 DOI: 10.1902/jop.2010.100443] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND This report is a further analysis of a study designed to determine clinical and microbial risk indicators for progressing periodontitis. METHODS One hundred ninety subjects who were periodontally healthy or had early signs of periodontitis (age range: 20 to 40 years) were monitored clinically at 6-month intervals followed by supragingival cleaning. At each visit, gingival crevicular fluid (GCF) and blood were collected for determination of interleukin (IL)-1β content (in GCF) and IL-1 genotype (in blood). Interproximal sites with a >1.5-mm increase in clinical attachment over 18 months were considered disease active. Characteristics were compared between active and inactive subjects. RESULTS IL-1β levels in GCF increased with the severity of disease and correlated well with clinical signs of incipient disease. However, the IL-1 genotype did not show any significant associations with disease or the extent of disease. CONCLUSION Indicators of inflammation may be important clinical determinants of future periodontal disease progression, but the IL-1 genotype was not a risk indictor for early (slight) periodontitis as defined in this subject population.
Collapse
Affiliation(s)
- Philip Stashenko
- Department of Cytokine Biology, The Forsyth Institute, Boston, MA, USA
| | | | | | | | | | | |
Collapse
|
44
|
Quantification of five putative periodontal pathogens in female patients with and without chronic periodontitis by real-time polymerase chain reaction. Anaerobe 2010; 16:234-9. [DOI: 10.1016/j.anaerobe.2010.02.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 01/04/2010] [Accepted: 02/23/2010] [Indexed: 11/18/2022]
|
45
|
|
46
|
Detection of multiple pathogenic species in saliva is associated with periodontal infection in adults. J Clin Microbiol 2008; 47:235-8. [PMID: 19020069 DOI: 10.1128/jcm.01824-08] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We investigated whether certain bacterial species and their combinations in saliva can be used as markers for periodontitis. In 1,198 subjects, the detection of multiple species, rather than the presence of a certain pathogen, in saliva was associated with periodontitis as determined by the number of teeth with deepened periodontal pockets.
Collapse
|
47
|
Pirhan D, Atilla G, Emingil G, Sorsa T, Tervahartiala T, Berdeli A. Effect of MMP-1 promoter polymorphisms on GCF MMP-1 levels and outcome of periodontal therapy in patients with severe chronic periodontitis. J Clin Periodontol 2008; 35:862-70. [DOI: 10.1111/j.1600-051x.2008.01302.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|