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Prevalence of the JP2 genotype of Aggregatibacter actinomycetemcomitans in the world population: a systematic review. Clin Oral Investig 2022; 26:2317-2334. [DOI: 10.1007/s00784-021-04343-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/09/2021] [Indexed: 12/11/2022]
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2
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Hbibi A, Bouziane A, Lyoussi B, Zouhdi M, Benazza D. Aggregatibacter actinomycetemcomitans: From Basic to Advanced Research. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:45-67. [DOI: 10.1007/978-3-030-96881-6_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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3
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Aggregatibacter actinomycetemcomitans and Aggregatibacter aphrophilus in a Kenyan Maasai Adolescent Population and Inhibition of Leukotoxic Activity by Herbal Plants Used as Part of Oral Hygiene Procedures. J Clin Med 2021; 10:jcm10225402. [PMID: 34830683 PMCID: PMC8621963 DOI: 10.3390/jcm10225402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/12/2021] [Accepted: 11/17/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND A virulent genotype (JP2) of the periodonto-pathogen, Aggregatibacter actinomycetemcomitans (Aa), is widespread in North and West Africa, while its presence in East Africa has not been thoroughly investigated. This JP2 genotype is associated with periodontitis in adolescents and has a high leukotoxicity. The aim of the study was to examine the prevalence of Aa and its JP2 genotype, the prevalence of the oral, commensal Aggregatibacter aphrophilus in a Maasai adolescent population, and the effect of herbal plants for inhibition of leukotoxicity. METHODS A total of 284 adolescents from Maasai Mara, Kenya, underwent an oral examination and microbial sampling. The presence of Aa and A. aphrophilus was analyzed by quantitative PCR and cultivation (the 58 samples collected at the last day of field study). The collected Aa strains were characterized and leukotoxin promoter typed. Additionally, herbal plants commonly used for oral hygiene were assessed for the inhibition of leukotoxicity. RESULTS AND CONCLUSIONS The prevalence of Aa in stimulated whole saliva was high (71.8%), with the JP2 genotype detected in one individual, and A. aphrophilus in 99% of the sampled individuals. The commonly used herbal plant, Warburgia ugandensis, inactivated Aa leukotoxicity. The Aa virulence might be reduced through use of W. ugandensis and the high levels of A. aphrophilus.
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Granehäll L, Huang KD, Tett A, Manghi P, Paladin A, O’Sullivan N, Rota-Stabelli O, Segata N, Zink A, Maixner F. Metagenomic analysis of ancient dental calculus reveals unexplored diversity of oral archaeal Methanobrevibacter. MICROBIOME 2021; 9:197. [PMID: 34593021 PMCID: PMC8485483 DOI: 10.1186/s40168-021-01132-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/01/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Dental calculus (mineralised dental plaque) preserves many types of microfossils and biomolecules, including microbial and host DNA, and ancient calculus are thus an important source of information regarding our ancestral human oral microbiome. In this study, we taxonomically characterised the dental calculus microbiome from 20 ancient human skeletal remains originating from Trentino-South Tyrol, Italy, dating from the Neolithic (6000-3500 BCE) to the Early Middle Ages (400-1000 CE). RESULTS We found a high abundance of the archaeal genus Methanobrevibacter in the calculus. However, only a fraction of the sequences showed high similarity to Methanobrevibacter oralis, the only described Methanobrevibacter species in the human oral microbiome so far. To further investigate the diversity of this genus, we used de novo metagenome assembly to reconstruct 11 Methanobrevibacter genomes from the ancient calculus samples. Besides the presence of M. oralis in one of the samples, our phylogenetic analysis revealed two hitherto uncharacterised and unnamed oral Methanobrevibacter species that are prevalent in ancient calculus samples sampled from a broad range of geographical locations and time periods. CONCLUSIONS We have shown the potential of using de novo metagenomic assembly on ancient samples to explore microbial diversity and evolution. Our study suggests that there has been a possible shift in the human oral microbiome member Methanobrevibacter over the last millennia. Video abstract.
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Affiliation(s)
- Lena Granehäll
- Institute for Mummy Studies, Eurac Research, 39100 Bolzano, Italy
- Faculty of Biology, Department of Biology II, Anthropology and Human Genomics, Ludwig-Maximilians-University of Munich, 82152 Planegg-Martinsried, Germany
| | - Kun D. Huang
- CIBIO Department, University of Trento, 38123 Trento, Italy
- Department of Sustainable Agro-Ecosystems and Bioresources, Fondazione Edmund Mach, 38010 San Michele all’Adige, Italy
| | - Adrian Tett
- CIBIO Department, University of Trento, 38123 Trento, Italy
- CUBE - Division of Computational Systems Biology, Centre for Microbiology and Environmental Systems Science, University of Vienna, Vienna, Austria
| | - Paolo Manghi
- CIBIO Department, University of Trento, 38123 Trento, Italy
| | - Alice Paladin
- Institute for Mummy Studies, Eurac Research, 39100 Bolzano, Italy
| | - Niall O’Sullivan
- Institute for Mummy Studies, Eurac Research, 39100 Bolzano, Italy
| | - Omar Rota-Stabelli
- Department of Sustainable Agro-Ecosystems and Bioresources, Fondazione Edmund Mach, 38010 San Michele all’Adige, Italy
- Center Agriculture Food Environment, University of Trento, 38123 Trento, Italy
| | - Nicola Segata
- CIBIO Department, University of Trento, 38123 Trento, Italy
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, 39100 Bolzano, Italy
| | - Frank Maixner
- Institute for Mummy Studies, Eurac Research, 39100 Bolzano, Italy
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Manoharan L, Brundin M, Rakhimova O, Chávez de Paz L, Romani Vestman N. New Insights into the Microbial Profiles of Infected Root Canals in Traumatized Teeth. J Clin Med 2020; 9:jcm9123877. [PMID: 33260621 PMCID: PMC7760719 DOI: 10.3390/jcm9123877] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/21/2020] [Accepted: 11/25/2020] [Indexed: 12/31/2022] Open
Abstract
Traumatic dental injuries in young individuals are often exposed to the invasion of oral microorganisms that leads to pulp necrosis. Infective necrosis in permanent teeth not-fully-developed causes aberrant root formation. Regeneration endodontic treatments (RETs) have shown promising results by promoting continued root development by stem cells. Critical to the success of RET is the thorough disinfection of the pulpal space. To establish effective antimicrobial protocols for root canal disinfection, the invading microorganisms need to be identified. In the present study, we use a combination of culture-based and high-throughput molecular sequencing techniques to investigate the microbial profiles from traumatized teeth (30 cases) and controls, i.e., teeth with pulp infections not caused by trauma (32 cases). Overall, a high microbial diversity in traumatized necrotic teeth was observed. Eubacterium yurii subsps. yurii and margaretiae, as well as key ‘bridging oral species’ F. nucleatum sp., Polymorphum and Corynebacterium matruchotti, were highly associated with traumatized teeth. The microbial compositions of traumatized teeth differed considerably from those of infected teeth not caused by trauma. Age and tooth position also influence microbial compositions. In conclusion, we show that the root canal microflora of traumatized teeth is highly diverse, and it differs from root canal infections not caused by trauma.
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Affiliation(s)
- Lokeshwaran Manoharan
- National Bioinformatics Infrastructure Sweden (NBIS), Lund University, 22362 Lund, Sweden;
| | - Malin Brundin
- Department of Endodontics, Umeå University, 90187 Umeå, Sweden;
| | - Olena Rakhimova
- Department of Odontology, Umeå University, 90187 Umeå, Sweden;
| | | | - Nelly Romani Vestman
- Department of Endodontics, County Council of Västerbotten, 90189 Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, 90187 Umeå, Sweden
- Correspondence:
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Oscarsson J, Claesson R, Bao K, Brundin M, Belibasakis GN. Phylogenetic Analysis of Filifactor alocis Strains Isolated from Several Oral Infections Identified a Novel RTX Toxin, FtxA. Toxins (Basel) 2020; 12:toxins12110687. [PMID: 33143036 PMCID: PMC7692872 DOI: 10.3390/toxins12110687] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 12/16/2022] Open
Abstract
Filifactor alocis is a Gram-positive asaccharolytic, obligate anaerobic rod of the phylum Firmicutes, and is considered an emerging pathogen in various oral infections, including periodontitis. We here aimed to perform phylogenetic analysis of a genome-sequenced F. alocis type strain (ATCC 35896; CCUG 47790), as well as nine clinical oral strains that we have independently isolated and sequenced, for identification and deeper characterization of novel genomic elements of virulence in this species. We identified that 60% of the strains carried a gene encoding a hitherto unrecognized member of the large repeats-in-toxins (RTX) family, which we have designated as FtxA. The clinical infection origin of the ftxA-positive isolates largely varied. However, according to MLST, a clear monophylogeny was reveled for all ftxA-positive strains, along with a high co-occurrence of lactate dehydrogenase (ldh)-positivity. Cloning and expression of ftxA in E. coli, and purification of soluble FtxA yielded a protein of the predicted molecular size of approximately 250 kDa. Additional functional and proteomics analyses using both the recombinant protein and the ftxA-positive, and -negative isolates may reveal a possible role and mechanism(s) of FtxA in the virulence properties of F.alocis, and whether the gene might be a candidate diagnostic marker for more virulent strains.
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Affiliation(s)
- Jan Oscarsson
- Division of Oral Microbiology, Department of Odontology, Umeå University, 90187 Umeå, Sweden;
- Correspondence:
| | - Rolf Claesson
- Division of Oral Microbiology, Department of Odontology, Umeå University, 90187 Umeå, Sweden;
| | - Kai Bao
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (G.N.B.)
| | - Malin Brundin
- Division of Endodontics, Department of Odontology, Umeå University, 90187 Umeå, Sweden;
| | - Georgios N. Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (G.N.B.)
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Comparison of the oral microbiome of patients with generalized aggressive periodontitis and periodontitis-free subjects. Arch Oral Biol 2019; 99:169-176. [PMID: 30710838 DOI: 10.1016/j.archoralbio.2019.01.015] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The primary objectives of the study were to assess differences in complex subgingival bacterial composition between periodontitis-free persons and patients with generalized aggressive periodontitis (gAgP). BACKGROUND The composition of the oral microbiota plays an important role for both oral and systemic diseases. However, the complex nature of the oral microbiome and its homeostasis is still poorly understood. MATERIAL AND METHODS We compared the microbiome of 13 periodontitis-free persons to 13 patients with gAgP. The 16S rRNA genes were amplified, targeting the V3/V4 region using the MiSeq platform. RESULTS In total, 1713 different bacterial species were mapped according to the Greengenes database. Using the Shannon index, no significant differences in alpha diversity were found between the two study groups. In principal component and linear discriminant analyses, disease-specific differences in beta diversity of the microbiome composition were evaluated. Bacteroidetes, Spirochaetes, and Synergistetes were more abundant in gAgP whereas Proteobacteria, Firmicutes, and Actinobacteria were associated with a healthy periodontium. At the bacterial species level, we showed that Porphyromonas gingivalis is the strongest indicator of gAgP. Treponema denticola and Tanerella forsythia of the "red complex" as well as Filifactor alocis were among the ten best biomarkers for gAgP. CONCLUSIONS These results broaden our knowledge of disease-specific differences in the microbial community associated with generalized AgP. A more complex view of the composition of the oral microbiome describes the etiology of generalized AgP in more detail. These results could help to individually adapt periodontal therapy in these patients.
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Fine DH, Patil AG, Loos BG. Classification and diagnosis of aggressive periodontitis. J Periodontol 2018; 89 Suppl 1:S103-S119. [DOI: 10.1002/jper.16-0712] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 10/11/2017] [Accepted: 10/21/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Daniel H. Fine
- Department of Oral Biology; Rutgers School of Dental Medicine; Rutgers University - Newark; NJ USA
| | - Amey G. Patil
- Department of Oral Biology; Rutgers School of Dental Medicine; Rutgers University - Newark; NJ USA
| | - Bruno G. Loos
- Department of Periodontology; Academic Center of Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
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Fine DH, Patil AG, Loos BG. Classification and diagnosis of aggressive periodontitis. J Clin Periodontol 2018; 45 Suppl 20:S95-S111. [DOI: 10.1111/jcpe.12942] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 10/11/2017] [Accepted: 10/21/2017] [Indexed: 12/30/2022]
Affiliation(s)
- Daniel H. Fine
- Department of Oral Biology; Rutgers School of Dental Medicine; Rutgers University - Newark; NJ USA
| | - Amey G. Patil
- Department of Oral Biology; Rutgers School of Dental Medicine; Rutgers University - Newark; NJ USA
| | - Bruno G. Loos
- Department of Periodontology; Academic Center of Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
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Microbiological analysis and the outcomes of periodontal treatment with or without adjunctive systemic antibiotics—a retrospective study. Clin Oral Investig 2018; 22:3031-3041. [DOI: 10.1007/s00784-018-2392-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 02/14/2018] [Indexed: 02/06/2023]
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Zein Elabdeen HR, Mustafa M, Ali R, Bolstad AI. Cytokine profile in gingival crevicular fluid and plasma of patients with aggressive periodontitis. Acta Odontol Scand 2017; 75:616-622. [PMID: 28868949 DOI: 10.1080/00016357.2017.1372623] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study aimed to determine the content of cytokines in gingival crevicular fluid (GCF) as well as in plasma of Sudanese patients with aggressive periodontitis (AgP) and healthy controls (HC). MATERIALS AND METHODS Nineteen AgP patients and 19 HC were included. The mean probing pocket depth and clinical attachment level of the GCF sampled sites in patients were both ≥5 mm. The GCF and plasma levels of 27 cytokines were determined using 27-multiplex fluorescent bead-based immunoassays. Ratios were calculated among cytokines of the T-helper cell subsets Th1 and Th2. Descriptive statistics, the Mann-Whitney U-test and Spearman's rho rank correlation coefficient analysis were used. RESULTS Interferon-γ was the only cytokine found in significantly lower levels in GCF of patients compared with HC. Levels of interleukin (IL)-10, IL-13, IL-1Ra, monocyte chemoattractant protein-1 (MCP-1), regulated on activation normal T-cell expressed and secreted (RANTES), granulocyte-colony-stimulating factor (G-CSF), and granulocyte-macrophage-CSF (GM-CSF) were significantly lower in plasma of AgP compared with HC. The ratios of Th1:Th2 in GCF and Treg:Th17 in plasma were significantly lower in AgP. CONCLUSIONS The lower levels of cytokines detected systemically in plasma of AgP patients may have an impact on the immune response. The lower ratio of Th1:Th2 cytokines in GCF samples of AgP patients suggests a role for Th2 at the local site of disease.
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Affiliation(s)
| | - Manal Mustafa
- Department of Clinical Dentistry – Periodontics, University of Bergen, Bergen, Norway
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
| | - Raouf Ali
- Faculty of Dentistry, University of Science and Technology, Omdurman, Sudan
| | - Anne Isine Bolstad
- Department of Clinical Dentistry – Periodontics, University of Bergen, Bergen, Norway
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Hashim N, Linden G, Winning L, Ibrahim M, Gismalla B, Lundy F, El Karim I. Putative periodontal pathogens in the subgingival plaque of Sudanese subjects with aggressive periodontitis. Arch Oral Biol 2017; 81:97-102. [DOI: 10.1016/j.archoralbio.2017.04.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 04/20/2017] [Accepted: 04/21/2017] [Indexed: 12/26/2022]
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Van der Velden U. What exactly distinguishes aggressive from chronic periodontitis: is it mainly a difference in the degree of bacterial invasiveness? Periodontol 2000 2017; 75:24-44. [DOI: 10.1111/prd.12202] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Influence of Type 2 Diabetes on Prevalence of Key Periodontal Pathogens, Salivary Matrix Metalloproteinases, and Bone Remodeling Markers in Sudanese Adults with and without Chronic Periodontitis. Int J Dent 2016; 2016:6296854. [PMID: 26989414 PMCID: PMC4773545 DOI: 10.1155/2016/6296854] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/29/2015] [Accepted: 01/13/2016] [Indexed: 12/11/2022] Open
Abstract
This study compared the influence of type 2 diabetes on the occurrence of six periodontal pathogens in plaque samples of patients with and without chronic periodontitis. Levels of salivary MMP-8, MMP-9, RANKL, and OPG were also investigated. The study enrolled 31 patients with type 2 diabetes and chronic periodontitis (DM + CP), 29 with chronic periodontitis (CP), and 20 with type 2 diabetes (DM). Questionnaire-guided interviews were conducted and plaque index, bleeding on probing, and pocket depth were recorded. Polymerase chain reaction (PCR) was utilized to determine the prevalence of the bacteria. The levels of salivary molecules were determined by enzyme immunosorbent assay (ELISA). The CP group had the highest prevalence of P. gingivalis (81.5%), followed by the DM + CP (59.3%) and DM (55.0%) groups (P > 0.05). Similar trends were observed for P. intermedia and T. denticola. The prevalence of T. forsythia was 100% in both periodontitis groups compared to 90% in the DM group. There were no significant differences between the groups regarding the concentrations of MMP-8, MMP-9, or OPG. RANKL concentrations were below the detection limit. Our data show that type 2 diabetes has no significant influence on the prevalence of the investigated periodontal pathogens, or the levels of salivary MMP-8, MMP-9, and OPG.
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Li Y, Feng X, Xu L, Zhang L, Lu R, Shi D, Wang X, Chen F, Li J, Meng H. Oral microbiome in chinese patients with aggressive periodontitis and their family members. J Clin Periodontol 2015; 42:1015-23. [PMID: 26412568 DOI: 10.1111/jcpe.12463] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Yi Li
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - Xianghui Feng
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - Li Xu
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - Li Zhang
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - Ruifang Lu
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - Dong Shi
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - Xiane Wang
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - Feng Chen
- Central laboratory; Peking University School and Hospital of Stomatology; Beijing China
| | - Jie Li
- BGI; Beishan Industrial Zone; Guangdong China
| | - Huanxin Meng
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
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Claesson R, Gudmundson J, Åberg CH, Haubek D, Johansson A. Detection of a 640-bp deletion in the Aggregatibacter actinomycetemcomitans leukotoxin promoter region in isolates from an adolescent of Ethiopian origin. J Oral Microbiol 2015; 7:26974. [PMID: 25881573 PMCID: PMC4400299 DOI: 10.3402/jom.v7.26974] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 03/03/2015] [Accepted: 03/10/2015] [Indexed: 11/17/2022] Open
Abstract
The expression of the leukotoxin of Aggregatibacter actinomycetemcomitans is regulated by the leukotoxin promoter. A 530-bp deletion or an 886-bp insertion sequence (IS) element in this region has earlier been described in highly leukotoxic isolates. Here, we report on highly leukotoxic isolate with a 640-bp deletion, which was detected in an adolescent of Ethiopian origin.
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Affiliation(s)
- Rolf Claesson
- Division of Oral Microbiology, Department of Odontology, Umeå University, Umeå, Sweden;
| | - Jan Gudmundson
- Periodontology Specialist Clinic, Östersunds Hospital, Östersund, Sweden
| | - Carola Höglund Åberg
- Division of Molecular Periodontology, Department of Odontology, Umeå University, Umeå, Sweden
| | - Dorte Haubek
- Section for Pediatric Dentistry, Department of Dentistry, Health, Aarhus University, Aarhus, Denmark
| | - Anders Johansson
- Division of Molecular Periodontology, Department of Odontology, Umeå University, Umeå, Sweden
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