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Escobar-Arregocés F, Eras MA, Bustos A, Suárez-Castillo A, García-Robayo DA, Del Pilar Bernal M. Characterization of the oral microbiota and the relationship of the oral microbiota with the dental and periodontal status in children and adolescents with nonsyndromic cleft lip and palate. Systematic literature review and meta-analysis. Clin Oral Investig 2024; 28:245. [PMID: 38587683 PMCID: PMC11001721 DOI: 10.1007/s00784-024-05624-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To identify the characteristics of the oral microbiota and the relationship of the dental caries and periodontal status in patients aged 0 to 18 years with non-syndromic cleft lip and palate (CLP). MATERIALS AND METHODS A systematic review of the literature was carried out. Five databases were consulted, including publications in English, Spanish and Portuguese. The evaluations of the quality of the observational studies and the experimental studies were carried out with the Newcastle-Ottawa scale and CONSORT guidelines, respectively. The risk of bias of the studies was determined using Rev Manager 5.4, and 5 publications were meta-analyzed. RESULTS The cariogenic microbiota of children and adolescents with cleft lip and palate was similar to that of children without clefts, although with higher counts of Streptococcus mutans and Lactobacillus spp. The periodontopathogenic microbiota was related to the presence of Campylobacter spp, Fusobacterium spp, Fusobacterium nucleatum, Prevotella intermedia/nigrescens, Parvimonas micra and Porphyromonas gingivalis, considered microorganisms with high pathogenic capacity. Heterogeneity was shown in relation to the microbiota and the type of fissure, presenting numerous microorganisms associated with the pre- and post-surgical condition (cheilorrhaphy and palatorrhaphy) such as Staphylococcus aureus, Streptococcus beta hemolyticus, Klebsiella pneumoniae and Klebsiella oxytoca, Moraxella catarrhalis, Candida spp, Candida albicans, Candida krusei and Candida tropicalis. The meta-analysis revealed that patients with cleft lip and palate were 2.03 times more likely to have caries than the control group (p<0.005). CONCLUSION In the microbiota, there was a great diversity of microorganisms that can vary according to the type of fissure and surgical interventions predisposing patients to a greater probability of dental caries, it is important to take into account the technique used to describe the oral microbiota in order to be able to compare the different studies. CLINICAL RELEVANCE Studying the microbiota and the relationship of dental caries and periodontal status in children and adolescents with cleft lip and palate can facilitate the comprehensive care of patients with these conditions.
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Affiliation(s)
- Francina Escobar-Arregocés
- Center of Dental Research, Member of the interdisciplinary team for the care of patients with CLP, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia.
| | - Mayra-Alexandra Eras
- Pediatric Dentistry, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia
| | - Andrea Bustos
- Pediatric Dentistry, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia
| | - Angela Suárez-Castillo
- Public Health, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia
| | - Dabeiba-Adriana García-Robayo
- Biological Science, Center of Dental Research, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia
| | - Maria Del Pilar Bernal
- Pediatric Stomatology, Member of the interdisciplinary team for the care of patients with CLP, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia
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Arboleda V, Elsouri KN, Heiser SE, Bernal I, Kesselman MM, Demory Beckler M. Oral Microbiome as a Tool of Systemic Disease on Cleft Patients: A New Landscape. Cureus 2023; 15:e35444. [PMID: 36994247 PMCID: PMC10041940 DOI: 10.7759/cureus.35444] [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: 01/08/2023] [Accepted: 02/24/2023] [Indexed: 03/31/2023] Open
Abstract
The oral cavity microbiome comprises benign and pathogenic bacteria, with more than 700 species identified. However, the current literature regarding resident bacterial flora in the oropharyngeal cavities in cleft lip/palate (CLP) patients still needs to be completed. This review aims to evaluate the role of the oral microbiome of cleft patients as an indicator in systemic diseases for which cleft patients might be at higher risk in the short or long term. A literature review was performed in July 2020 using Biomedical Reference Collection Comprehensive, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Dentistry & Oral Sciences Source via Elton B. Stephens Company/Online Database (EBSCO), Turning Research into Practice (TRIP), and PubMed. The keywords used were "oral, bacteria, microbiome, biota, flora, cleft, palate." The resulting 466 articles were deduplicated using Endnote. The total amount of articles' abstracts without duplicates was filtered using a set criterion. The title and abstract filter criteria included 1) cleft lip (CL) and/or cleft palate (CP) patients, 2) changes in the oral microbiome in CL and/or CP patients, 3) male and female patients 0-21 years old, and 4) English language. The full-text filter criteria included 1) CL and/or CP patients vs. non-cleft control patients, 2) oral bacteria, 3) nonprocedural measurements of microorganisms, and 4) case-control studies. A Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) flow chart was created using the EndNote data results. The final five articles of the systematic search indicated that the oral cavity of cleft lip and/or palate patients resulted in 1) contradicting levels of Streptococcus mitis and Streptococcus salivarius; 2) lower levels of Streptococcus gordonii, Bordetella dentium, Fusobacterium nucleatum, Veillonella parvula, Bacillus and Lautropia when compared to the control group; 3) higher levels of Staphylococcus epidermidis and Methicillin-sensitive Staphylococcus aureus compared to the control group; 4) presence of Enterobacter cloacae 36.6%, Klebsiella pneumoni 53.3%, and Klebsiella oxytoca 76.6% vs. absence in the control non-cleft group. Patients with CL and/or CP are at higher risk for caries, periodontal diseases, and upper and lower respiratory infections. The results from this review indicate that relative levels of certain bacteria may be associated with these issues. The lower levels of S. mitis, S. salivarius, S. gordini, and F. nucleatum in the oral cavity of cleft patients could be linked as a possible cause of the higher incidence of tooth decay, gingivitis and periodontal disease as high levels of these bacteria are associated with oral disease. Further, the higher incidence of sinusitis in cleft patients might be linked to low levels of S. salivarius in the oral profile of these patients. Likewise, E. cloacae, K. oxycota, and K. pneumoni have been linked with pneumonia and bronchiolitis, both of which are increased in cleft patients. The oral bacterial dysbiosis of cleft patients observed in this review may play a vital function in the oral microbiome's diversity, which could play a role in disease progression and disease markers. The pattern seen in cleft patients potentially demonstrates how structural abnormalities can lead to the onset of severe infection.
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Affiliation(s)
- Vania Arboleda
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Kawther N Elsouri
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Samantha E Heiser
- Osteopathic Medicine, William Carey University College of Osteopathic Medicine, Hattiesburg, USA
| | - Isabel Bernal
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Marc M Kesselman
- Rheumatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Michelle Demory Beckler
- Microbiology and Immunology, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
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Gershater E, Liu Y, Xue B, Shin MK, Koo H, Zheng Z, Li C. Characterizing the microbiota of cleft lip and palate patients: a comprehensive review. Front Cell Infect Microbiol 2023; 13:1159455. [PMID: 37143743 PMCID: PMC10152472 DOI: 10.3389/fcimb.2023.1159455] [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: 02/06/2023] [Accepted: 03/31/2023] [Indexed: 05/06/2023] Open
Abstract
Orofacial cleft disorders, including cleft lip and/or palate (CL/P), are one of the most frequently-occurring congenital disorders worldwide. The health issues of patients with CL/P encompass far more than just their anatomic anomaly, as patients with CL/P are prone to having a high incidence of infectious diseases. While it has been previously established that the oral microbiome of patients with CL/P differs from that of unaffected patients, the exact nature of this variance, including the relevant bacterial species, has not been fully elucidated; likewise, examination of anatomic locations besides the cleft site has been neglected. Here, we intended to provide a comprehensive review to highlight the significant microbiota differences between CL/P patients and healthy subjects in various anatomic locations, including the teeth inside and adjacent to the cleft, oral cavity, nasal cavity, pharynx, and ear, as well as bodily fluids, secretions, and excretions. A number of bacterial and fungal species that have been proven to be pathogenic were found to be prevalently and/or specifically detected in CL/P patients, which can benefit the development of CL/P-specific microbiota management strategies.
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Affiliation(s)
| | - Yuan Liu
- Biofilm Research Laboratories, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Binglan Xue
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Min Kyung Shin
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Hyun Koo
- Biofilm Research Laboratories, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Innovation & Precision Dentistry, School of Dental Medicine and School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA, United States
| | - Zhong Zheng
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- *Correspondence: Zhong Zheng, ; Chenshuang Li,
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States
- *Correspondence: Zhong Zheng, ; Chenshuang Li,
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Grewcock RE, Innes NP, Mossey PA, Robertson MD. Caries in children with and without orofacial clefting; Systematic Review and Meta-Analysis. Oral Dis 2022; 28:1400-1411. [PMID: 35263806 PMCID: PMC9314085 DOI: 10.1111/odi.14183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/24/2022] [Accepted: 03/04/2022] [Indexed: 11/28/2022]
Abstract
This systematic review compared children's primary dentition caries experience for those with cleft lip and/or palate (CL/P) and without. Four databases were searched without date restriction for; cross‐sectional studies comparing caries experience for children with CL/P to those without. Screening, data extraction and risk assessment were carried out independently (in duplicate). Meta‐analyses used a random‐effects model. Twenty studies (21 reports) fitting the inclusion criteria comprised 4647 children in primary dentition from 12 countries. For dmft (n = 3016 children; 15 groups), CL/P mean = 3.2; standard deviation = 2.22 and no CL/P mean dmft = 2.5; sd 1.53. For dmfs (n = 1095 children; 6 groups), CL/P mean = 4; sd = 3.5 and no CL/P mean = 3; sd = 2.8. For % caries experience (n = 1094 children; 7 groups), CL/P mean = 65%; sd = 20.8 and no CL/P mean = 52%; sd = 28.1. Meta‐analysis showed higher caries experience in children with CL/P, standardised mean difference = 0.46; 95% CI = 0.15, 0.77. Studies' risk of bias was high (n = 7), medium (n−10) and low (n = 3). Children with CL/P had higher caries experience compared to those without CLP.
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Affiliation(s)
- R E Grewcock
- Dental Hospital and School, University of Dundee, Park Place, Dundee, DD1 4HN, UK
| | - N P Innes
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK
| | - P A Mossey
- Dental Hospital and School, University of Dundee, Park Place, Dundee, DD1 4HN, UK
| | - M D Robertson
- Dental Hospital and School, University of Dundee, Park Place, Dundee, DD1 4HN, UK
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Ettinger M. [Digital technologies]. DER ORTHOPADE 2021; 50:785-788. [PMID: 34505909 DOI: 10.1007/s00132-021-04156-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Max Ettinger
- MHH Klinik für Orthopädie, Annastift, Anna-von-Borries-Str. 1-7, 30625, Hannover, Deutschland.
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Dhillon H, Chaudhari PK, Dhingra K, Kuo RF, Sokhi RK, Alam MK, Ahmad S. Current Applications of Artificial Intelligence in Cleft Care: A Scoping Review. Front Med (Lausanne) 2021; 8:676490. [PMID: 34395471 PMCID: PMC8355556 DOI: 10.3389/fmed.2021.676490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 06/30/2021] [Indexed: 01/30/2023] Open
Abstract
Objective: This scoping review aims to identify the various areas and current status of the application of artificial intelligence (AI) for aiding individuals with cleft lip and/or palate. Introduction: Cleft lip and/or palate contributes significantly toward the global burden on the healthcare system. Artificial intelligence is a technology that can help individuals with cleft lip and/or palate, especially those in areas with limited access to receive adequate care. Inclusion Criteria: Studies that used artificial intelligence to aid the diagnosis, treatment, or its planning in individuals with cleft lip and/or palate were included. Methodology: A search of the Pubmed, Embase, and IEEE Xplore databases was conducted using search terms artificial intelligence and cleft lip and/or palate. Gray literature was searched using Google Scholar. The study was conducted according to the PRISMA- ScR guidelines. Results: The initial search identified 458 results, which were screened based on title and abstracts. After the screening, removal of duplicates, and a full-text reading of selected articles, 26 publications were included. They explored the use of AI in cleft lip and/or palate to aid in decisions regarding diagnosis, treatment, especially speech therapy, and prediction. Conclusion: There is active interest and immense potential for the use of artificial intelligence in cleft lip and/or palate. Most studies currently focus on speech in cleft palate. Multi-center studies that include different populations, with collaboration amongst academicians and researchers, can further develop the technology.
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Affiliation(s)
- Harnoor Dhillon
- Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhat Kumar Chaudhari
- Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Kunaal Dhingra
- Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Rong-Fu Kuo
- Medical Device Innovation Centre, National Cheng Kung University, Tainan, Taiwan
| | - Ramandeep Kaur Sokhi
- Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | | | - Shandar Ahmad
- School of Computational and Integrative Sciences, Jawaharlal Nehru University, New Delhi, India
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