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Plata JC, Díaz-Báez D, Delgadillo NA, Castillo DM, Castillo Y, Hurtado CP, Neuta Y, Calderón JL, Lafaurie GI. Hypochlorous Acid as a Potential Postsurgical Antimicrobial Agent in Periodontitis: A Randomized, Controlled, Non-Inferiority Trial. Antibiotics (Basel) 2023; 12:1311. [PMID: 37627732 PMCID: PMC10451621 DOI: 10.3390/antibiotics12081311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Hypochlorous acid (HOCl) is an antimicrobial agent with high affinity to Gram-negative bacteria of the subgingival biofilm. It could have an equivalent or no inferiority effect to chlorhexidine (CHX) to avoid recolonization of these microorganisms after the post-surgical period. OBJECTIVE The objective is to compare the reduction of plaque index (PI), gingival index (GI), pocket depth (PD), gain of clinical attachment level (CAL), and bacterial recolonization of periodontopathic microorganisms in subgingival biofilm at 7, 21, and 90 days after Open Flap Debridement (OFD) under two antimicrobial protocols: (A) HOCl 0.05% followed by HOCl 0.025% and (B) CHX 0.2%/CHX 0.12% used per 21 days without regular oral hygiene during the post-surgical period. MATERIAL AND METHODS A no-inferiority randomized controlled trial was carried out. Thirty-two patients were randomly divided to receive each antiplaque protocol after OFD in patients with periodontitis. Clinical indexes and bacterial recolonization were assessed using qPCR for up to 90 days. Data were analyzed using repeated measures ANOVA, mixed effects models adjusted for treatment, time, and the Chi-squared/Fisher test. A no-inferiority analysis was also performed using the Hodges-Lehmann hypothesis test for non-inferiority. RESULTS HOCl was not inferior to CHX in reducing PI. Both groups showed a comparable reduction of recolonization for Porphyromonas gingivalis, Tannerella forsythia, and Eubacterium nodatum. However, the HOCl protocol was non-inferior to the CHX protocol for Treponema denticola and Aggregatibacter actinomicetemcomitans. CONCLUSIONS HOCl improved periodontal healing. HOCl showed an impact in reducing the recolonization of periodontopathic bacteria in the postoperative period.
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Affiliation(s)
- Julio Cesar Plata
- Master’s Program in Dental Sciences, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia;
- School of Dentistry, Universidad Cooperativa de Colombia, Bucaramanga P.O. Box 680001, Colombia;
| | - David Díaz-Báez
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Nathaly Andrea Delgadillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Diana Marcela Castillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Yormaris Castillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Claudia Patricia Hurtado
- School of Dentistry, Universidad Cooperativa de Colombia, Bucaramanga P.O. Box 680001, Colombia;
| | - Yineth Neuta
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Justo Leonardo Calderón
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Gloria Inés Lafaurie
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
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Lafaurie GI, Castillo DM, Iniesta M, Sanz M, Gómez LA, Castillo Y, Pianeta R, Delgadillo NA, Neuta Y, Diaz-Báez D, Herrera D. Differential analysis of culturable and unculturable subgingival target microorganisms according to the stages of periodontitis. Clin Oral Investig 2023; 27:3029-3043. [PMID: 36806930 PMCID: PMC10264511 DOI: 10.1007/s00784-023-04907-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/03/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVES Culturable and unculturable microorganisms have been associated with periodontitis. Their differential proportions and composition have not been evaluated by their severity and complexity defined by stages in the 2018 AAP-EEP classification. METHODS One hundred eighty subgingival biofilm samples were collected in Spain and Colombia from subjects categorized as health/gingivitis: periodontitis stages I/II periodontitis stages III/IV. Target culturable microorganisms (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Treponema denticola, and Eubacterium nodatum) and target unculturable microorganisms (Filifactor alocis, Eubacterium saphenum, Eubacterium brachy, Desulfobulbus oralis) were evaluated by quantitative PCR analysis. In addition, their differences and association with periodontal status were analyzed by ANCOVA and logistic regression models once adjusted to age, current smoking, and country. RESULTS P. gingivalis was significantly associated with periodontitis stages I/II, OR 2.44 (CI 95% 1.08-5.47) and stages III/V, OR 6.43 (CI 95% 2.43-16.9). T forsythia, OR 7.53 (CI 95% 2.07-27.4); D. oralis, OR 5.99 (CI 95% 2.71-13.23); F. alocis, OR 10.9 (CI 95% 4.56-23.2); E. brachy, 3.57 (CI 95% 1.40-9.11); and E. saphenum, 4.85 (CI 95% 1.99-11.7) were significantly associated only with stages III/IV periodontitis. P. gingivalis evidenced significant differences with the increase in the severity of the periodontal lesion: 2.97 colony forming unit (CFU)/μL (CI 95% 2.32-3.54) health/gingivitis, and 4.66 CFU/μL (CI 95% 4.03-5.30) and 5.90 CFU/μL (CI 95% 5.20-6.48) in stages I/II and III/IV respectively (p < 0.0001). Unculturable microorganisms only evidenced differences in concentration in stages III/IV compared with health-gingivitis (p ≤ 0.001). CONCLUSION Culturable and unculturable are strongly associated with stages III/IV periodontitis. Classic culturable microorganisms are more sensitive to differentiate between stages of periodontitis in the quantitative analysis. CLINICAL RELEVANCE Future interventional studies of periodontal disease should include Filifactor alocis, Eubacterium saphenum, Eubacterium brachy, and Desulfobulbus oralis as possible markers of therapy response and as indicators of progressive disease.
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Affiliation(s)
- Gloria Inés Lafaurie
- Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Ak. 9 #13, 1a-20 Bogotá, Colombia
| | - Diana Marcela Castillo
- Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Ak. 9 #13, 1a-20 Bogotá, Colombia
| | - Margarita Iniesta
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, School of Dentistry, University Complutense of Madrid (UCM), Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, School of Dentistry, University Complutense of Madrid (UCM), Madrid, Spain
| | - Luz Amparo Gómez
- Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Ak. 9 #13, 1a-20 Bogotá, Colombia
| | - Yormaris Castillo
- Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Ak. 9 #13, 1a-20 Bogotá, Colombia
| | - Roquelina Pianeta
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, School of Dentistry, University Complutense of Madrid (UCM), Madrid, Spain
- School of Dentistry, Corporación Universitaria Rafael Núñez, Cartagena, Colombia
| | - Nathaly Andrea Delgadillo
- Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Ak. 9 #13, 1a-20 Bogotá, Colombia
| | - Yineth Neuta
- Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Ak. 9 #13, 1a-20 Bogotá, Colombia
| | - David Diaz-Báez
- Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Ak. 9 #13, 1a-20 Bogotá, Colombia
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, School of Dentistry, University Complutense of Madrid (UCM), Madrid, Spain
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Marin MJ, Figuero E, Herrera D, Sanz M. Quantitative Analysis of Periodontal Pathogens Using Real-Time Polymerase Chain Reaction (PCR). Methods Mol Biol 2023; 2588:157-169. [PMID: 36418687 DOI: 10.1007/978-1-0716-2780-8_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The quantitative polymerase chain reaction (qPCR) is a variant of PCR aimed to detect and quantify a targeted DNA molecule. This is made through the addition of probes labeled with fluorescent molecules that emit fluorescence within each amplification cycle, resulting in fluorescence values proportional to the amount of accumulated PCR product. This chapter presents the detailed procedures for quantification of different periodontal pathogens (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Campylobacter rectus, Streptococcus oralis, and Fusobacterium spp.) using qPCR. It also includes the description of the most frequent problems encountered, how to solve them, and recommendations to minimize the risks for laboratory staff handling oral samples. In addition, a detailed protocol for multiplex qPCR to detect and quantify Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Tannerella forsythia is also included.
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Affiliation(s)
- Mª José Marin
- Oral Research Laboratory, Faculty of Dentistry, University Complutense, Madrid, Spain
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Elena Figuero
- Oral Research Laboratory, Faculty of Dentistry, University Complutense, Madrid, Spain
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - David Herrera
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain.
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Simultaneous presence of Mycoplasma salivarium and Tannerella forsythia in the implant sulcus after lateral augmentation with autogenous root grafts is associated with increased sulcus probing depth. PLoS One 2022; 17:e0270962. [PMID: 35802644 PMCID: PMC9269361 DOI: 10.1371/journal.pone.0270962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 06/17/2022] [Indexed: 11/19/2022] Open
Abstract
Objective To characterize a potential pathogenic role of Mycoplasma salivarium and bacterial co-detection patterns on different implant augmentation types. Material and methods 36 patients were non-randomly assigned to autogenous lateral alveolar ridge augmentation with either cortical autogenous bone blocks, or healthy autogenous tooth roots or non-preservable teeth. Mucosal inflammation was assessed by probing pocket depth (PD) at all sampling sites and by bleeding on probing (BOP) in a subset of sampling sites, and standardized biofilm samples were obtained from the submucosal peri-implant sulcus and sulcus of a contralateral tooth at two times (t1 after implant placement; t2 after six months). Seven bacterial species were quantified using Taqman PCR. Results Mucosal inflammation did not differ between augmentation groups, but peri-implant sulci showed increased abundance of M. salivarium after augmentation with autogenous tooth roots lasting for at least six months (t1 p = 0.05, t2 p = 0.011). In M. salivarium-positive samples, Tannerella forsythia was correlated with PD (R = 0.25, p = 0.035) This correlation was not observed in M. salivarium-negative samples. Compared to all other samples, PD was deeper in co-detection (i.e., simultaneous M. salivarium and T. forsythia) positive samples (p = 0.022). No association of single or co-detection of bacteria with BOP was observed. Conclusion Presence of M. salivarium in peri-implant sulci varies with augmentation method and is associated with increased PD but not BOP. A potential causal role of M. salivarium in inflammation through a mechanism involving co-presence of T. forsythia requires further study.
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Romero-Sánchez C, Giraldo S, Heredia-P AM, De Avila J, Chila-Moreno L, Londoño J, Valle-Oñate R, Bello-Gualtero JM, Bautista-Molano W. Association of Serum and Crevicular Fluid Dickkopf-1 Levels with Disease Activity and Periodontitis in Patients with Early Rheumatoid Arthritis. Curr Rheumatol Rev 2021; 18:124-135. [PMID: 34784873 DOI: 10.2174/1573397117666211116105118] [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: 03/10/2021] [Revised: 06/30/2021] [Accepted: 08/10/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The aim of this study was to assess DKK-1 levels, in Gingival Crevicular Fluid (GCF) and serum, as a biomarker for bone loss and disease activity in periodontitis and early RA (eRA). METHODS In this cross-sectional study, we obtained serum and GCF from 10 interproximal sites (Distal Buccal I/S, Mesio Buccal I/S, Distal Palatal/Lingual, Mesio Palatal/Lingual) according to the highest degree of inflammation by a patient for 240 sites from eRA patients. Patients received a periodontal assessment, a radiographic evaluation, tomography of interproximal sites, and DKK1 levels were determined by ELISA. Comparisons were performed by the Mann-Whitney U test and analysis by Chi2 test, and a logistic regression model was applied. RESULTS The mean age was 46.33 ± 12.0 years, the Disease Activity Score (DAS-28-ESR) was 4.08 ± 1.4. Periodontitis was present in 65.2% of the patients, and 59.6% of these patients had bone loss in interproximal sites. Higher GCF-DKK1 levels were associated with serum-DKK1 (OR:2.41 IC95% 1.14-5.09, p=0.021) and were related with DAS28-ESR (p=0.001), Routine Assessment of Patient Index Data 3 (RAPID 3) (p=0.001), and tender joints (p=0.040). Foot bone erosion and juxta-articular osteopenia were associated with high levels of serum-DKK1 (p=0.009 and 0.001, respectively). Serum-DKK1 were associated with SDAI (OR: 2.38 IC95% 1.03-5.52, p=0.043), RAPID 3 (p=0.001), and rheumatoid factor (p=0.018). The GCF-DKK1 levels were associated with periodontal bone loss (p=0.011), periodontitis (p=0.070) and its severity (OR: 2.58 IC95% 2.28-7.28, p=0.001). Bone loss was more frequent in buccal sites (73.5%) and was associated with increased levels of DKK1 (p=0.033). CONCLUSION In the early stages of the eRA disease, serum and GCF-DKK1 could be a biomarker for clinical disease activity and periodontal and articular bone erosion.
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Affiliation(s)
- Consuelo Romero-Sánchez
- Cellular and Molecular Immunology Group/ INMUBO, School of Dentistry, Universidad El Bosque, Bogotá. Colombia
| | - Sebastián Giraldo
- Clinical Immunology Group, Rheumatology and Immunology Department Hospital Militar Central/School of Medicine, Universidad Militar Nueva Granada/, Bogotá. Colombia
| | - Ana María Heredia-P
- Cellular and Molecular Immunology Group/ INMUBO, School of Dentistry, Universidad El Bosque, Bogotá. Colombia
| | - Juliette De Avila
- Cellular and Molecular Immunology Group/ INMUBO, School of Dentistry, Universidad El Bosque, Bogotá. Colombia
| | - Lorena Chila-Moreno
- Cellular and Molecular Immunology Group/ INMUBO, School of Dentistry, Universidad El Bosque, Bogotá. Colombia
| | - John Londoño
- Spondyloarthropathy Group, Rheumatology Department, Hospital Militar Central/Universidad de La Sabana, Bogotá. Colombia
| | - Rafael Valle-Oñate
- Clinical Immunology Group, Rheumatology and Immunology Department Hospital Militar Central/School of Medicine, Universidad Militar Nueva Granada/, Bogotá. Colombia
| | - Juan Manuel Bello-Gualtero
- Clinical Immunology Group, Rheumatology and Immunology Department Hospital Militar Central/School of Medicine, Universidad Militar Nueva Granada/, Bogotá. Colombia
| | - Wilson Bautista-Molano
- Cellular and Molecular Immunology Group/ INMUBO, School of Dentistry, Universidad El Bosque, Bogotá. Colombia
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Identification of Periopathogenes from Dental Plaque in Periodontal Patients with PCR Technique and Their Association with Composite Interleukin-1 Genotype. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2019; 40:89-97. [PMID: 31605582 DOI: 10.2478/prilozi-2019-0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The present study aimed to assess the presence of main types of microorganisms involved in the aetiopathogenesis of chronic periodontitis with PCR technique and determinates the presence of composite IL-1 genotype and their associations with founded bacteria. MATERIAL AND METHOD The examined group was consisted from 20 subjects with diagnosed chronic periodontitis and 20 healthy control without periodontitis. Clinical parameters like gingival index (GI), plaque index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD) and clinical attachment lost (CAL) were determinates. Subgingival dental plaque was collected using a sterilized paper point. We used Parodontose Plus test, reverse hybridization kit, for the detection of periodontal marker bacteria, as well as for the detection of composite Interleukin -1 Genotype Results: The most present bacterial species detected from subgingival dental plaque was Treponema denticola and Porfiromonas gingivalis which was present in 65% of examined patients. In relation to the presence of positive genotype in patients, there was no significant difference between the test and control group for p> 0.05 (p = 1.00). For χ2=8,17 (p=0,06, p<0,05) there is an association between Prevotella intermedia, and composite genotype. Between positive genotype and analyzed bacterial species A. actinomycetem comitans for p> 0.05 (p = 1.00), P. gingivalis for p> 0.05 (p = 0.16), T. Forsythia for p> 0.05 (p = 0.20), T. Denticola for p> 0.05 (p = 0.64) no association was found. CONCLUSION This investigations confirmed the strong association of these five examined periopathogenes with periodontitis.
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Zhu B, Meng H, Huang B, Chen Z, Lu R. Detection of T. forsythia and other important bacteria in crestal and subcrestal implants with ligature-induced peri-implant infection in dogs. J Periodontol 2018; 90:306-313. [PMID: 30222195 DOI: 10.1002/jper.18-0223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/07/2018] [Accepted: 07/31/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND The study was designed to compare peri-implant microbial colonization of inflamed implants placed at different levels in dogs. METHODS Two screwed-in (SI) and two tapped-in (TI) conical connection implants were placed on each side of mandibles in six dogs respectively. Four experimental groups were constituted according to implant types and placement depth in one side: SI crestally (SIC), SI 1.5 mm subcrestally (SIS), TI crestally (TIC), and TI 1.5 mm subcrestally (TIS). Plaque accumulation of implants was promoted by cotton ligatures at either side randomly selected in each dog four weeks after abutment connection. Peri-implant sulcular fluid (PISF) samples were collected at 4 weeks, 10 weeks, and 16 weeks after abutment connection. Common periodontal pathogens in PISF were analyzed by PCR and realtime-PCR to investigate the influence of placement depth on microbial accumulation. The microbial results were further correlated with clinical parameters. RESULTS At ligatured sides, detection rates of T. forsythia and P. gingivalis increased significantly in four groups. T. forsythia levels increased significantly from baseline in four groups at ligatured sides at 16 weeks (p < 0.05). TIS group harbored significantly more T. forsythia than TIC at ligatured sides at 16 weeks (p < 0.05). At ligatured sides, probing depth was correlated to T. forsythia level in four groups as well as in total. CONCLUSIONS Subcrestal placement could increase the peri-implant T. forsythia level at the early stage of peri-implantitis. The T. forsythia level in the peri-implant sulcus is associated with probing depth.
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Affiliation(s)
- Bin Zhu
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Baoxin Huang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.,Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - ZhiBin Chen
- 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
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Marin MJ, Ambrosio N, Herrera D, Sanz M, Figuero E. Validation of a multiplex qPCR assay for the identification and quantification of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis: In vitro and subgingival plaque samples. Arch Oral Biol 2018; 88:47-53. [PMID: 29407751 DOI: 10.1016/j.archoralbio.2018.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To validate a multiplex qPCR (m-qPCR) assay for the simultaneous identification and quantification of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis in subgingival samples. MATERIAL AND METHODS In vitro samples: DNA combinations of A. actinomycetemcomitans and P. gingivalis in similar or different concentrations were prepared. qPCR and m-qPCR were performed using the same primers and hydrolysis probes specific for 16SrRNA genes. Results were analyzed using intra-class (ICCs) and Lin's correlation coefficients (r) based on quantification cycle (Cq) values. Subgingival plaque samples: a cross-sectional study analyzing subgingival plaque samples harvested from periodontally-healthy and chronic periodontitis patients. Samples were processed by either qPCR or m-qPCR targeting both bacteria. Sensitivity, specificity, predictive values and Lińs correlation coefficients (r) were calculated using CFU/mL as primary outcome. RESULTS In vitro samples: m-qPCR yielded a good reproducibility (coefficients of variation around 1% and ICCs > 0.99) for both bacterial species. m-qPCR achieved detection limits and specificity similar to qPCR. An excellent concordance (r = 0.99) was observed between m-qPCR and qPCR for A. actinomycetemcomitans and P. gingivalis without statistical significant differences between both methods Subgingival plaque samples: a high sensitivity (above 80%) and specificity (100%) was obtained with the m-qPCR for both bacteria. The m-qPCR yielded a good concordance in Cq values, showing a good level of agreement between qPCR and m-qPCR. CONCLUSION The tested m-qPCR method was successful in the simultaneous quantification of A. actinomycetemcomitans and P. gingivalis, with a high degree of sensitivity and specificity on subgingival plaque samples.
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Affiliation(s)
- M J Marin
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain.
| | - N Ambrosio
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - D Herrera
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - M Sanz
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - E Figuero
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
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Feres M, Figueiredo LC, Soares GMS, Faveri M. Systemic antibiotics in the treatment of periodontitis. Periodontol 2000 2017; 67:131-86. [PMID: 25494600 DOI: 10.1111/prd.12075] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2014] [Indexed: 12/12/2022]
Abstract
Despite the fact that several clinical studies have shown additional benefits when certain systemic antibiotics are used as adjuncts to periodontal treatment, clear guidelines for the use of these agents in the clinical practice are not yet available. Basic questions concerning the use of systemic antibiotics to treat periodontitis remain unanswered, such as: which drug(s) should be used; which patients would most benefit from treatment; which are the most effective protocols (i.e. doses and durations); and in which phase of the mechanical therapy should the drug(s) be administered? Although not all of those questions have been directly addressed by controlled randomized clinical trials, recent concepts related to the ecology of periodontal diseases, as well as the major advances in laboratory and clinical research methods that have occurred in the past decade, have significantly broadened our knowledge in this field. This article endeavored to provide a 'state of the art' overview on the use of systemic antibiotics in the treatment of periodontitis, based on the most recent literature on the topic as well as on a compilation of data from studies conducted at the Center of Clinical Trials at Guarulhos University (São Paulo, Brazil) from 2002 to 2012.
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Marin MJ, Ambrosio N, Virto L, Diz P, Álvarez M, Herrera D, Sanz M, Figuero E. Detection and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Streptococcus oralis in blood samples with different microbiological identification methods: An in vitro study. Arch Oral Biol 2017; 74:55-62. [DOI: 10.1016/j.archoralbio.2016.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 10/11/2016] [Accepted: 11/06/2016] [Indexed: 12/19/2022]
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Okada A, Sogabe K, Takeuchi H, Okamoto M, Nomura Y, Hanada N. Characterization of specimens obtained by different sampling methods for evaluation of periodontal bacteria. J Oral Sci 2017; 59:491-498. [DOI: 10.2334/josnusd.16-0573] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Ayako Okada
- Department of Translational Research, School of Dental Medicine, Tsurumi University
| | - Kaoru Sogabe
- Department of Translational Research, School of Dental Medicine, Tsurumi University
| | - Hiroaki Takeuchi
- Department of Translational Research, School of Dental Medicine, Tsurumi University
| | - Masaaki Okamoto
- Department of Translational Research, School of Dental Medicine, Tsurumi University
| | - Yoshiaki Nomura
- Department of Translational Research, School of Dental Medicine, Tsurumi University
| | - Nobuhiro Hanada
- Department of Translational Research, School of Dental Medicine, Tsurumi University
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Marin MJ, Figuero E, Herrera D, Sanz M. Quantitative Analysis of Periodontal Pathogens Using Real-Time Polymerase Chain Reaction (PCR). Methods Mol Biol 2017; 1537:191-202. [PMID: 27924595 DOI: 10.1007/978-1-4939-6685-1_11] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The quantitative polymerase chain reaction (qPCR) is a variant of PCR aimed to detect and quantify a targeted DNA molecule through the addition of probes labeled with fluorescent molecules that emit fluorescence within each amplification cycle, what results in fluorescence values proportional to the amount of accumulated PCR product. This chapter presents the detailed procedures for quantification of different periodontal pathogens (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Campylobacter rectus, and Fusobacterium spp.) using qPCR. It also includes the description of the most frequent problems encountered and how to solve them. In addition, a detailed protocol for multiplex qPCR to detect and quantify P. gingivalis and A. actinomycetemcomitans is included.
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Affiliation(s)
- Mª José Marin
- Oral Research Laboratory, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Elena Figuero
- Oral Research Laboratory, Faculty of Odontology, University Complutense, Madrid, Spain
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
- Department of Periodontology, Faculty of Dentistry, University Complutense of Madrid, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), Madrid, 28040, Spain
| | - David Herrera
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
- Department of Periodontology, Faculty of Dentistry, University Complutense of Madrid, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), Madrid, 28040, Spain
| | - Mariano Sanz
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain.
- Department of Periodontology, Faculty of Dentistry, University Complutense of Madrid, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), Madrid, 28040, Spain.
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Casarin M, Antoniazzi RP, Vaucher RA, Feldens CA, Zanatta FB. RT-PCR quantification of periodontal pathogens in crack users and non-users. Oral Dis 2016; 23:324-330. [DOI: 10.1111/odi.12609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 10/07/2016] [Accepted: 10/31/2016] [Indexed: 11/28/2022]
Affiliation(s)
- M Casarin
- Postgraduate Program in Dentistry; Federal University of Santa Maria; Santa Maria Brazil
| | - RP Antoniazzi
- Dentistry Course; Franciscan University Center; Santa Maria Brazil
| | - RA Vaucher
- Postgraduate Program in Biochemistry and Bioprospecting; Center of Chemistry; Pharmaceutical and Food Science; Federal University of Pelotas (UFPel); Pelotas Rio Grande do Sul Brazil
| | - CA Feldens
- Postgraduate Program in Dentistry; Lutheran University of Brazil; Canoas Brazil
| | - FB Zanatta
- Postgraduate Program in Dentistry; Federal University of Santa Maria; Santa Maria Brazil
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No evidence for the growth-stimulating effect of monomers on cariogenic Streptococci. Clin Oral Investig 2016; 21:1861-1869. [DOI: 10.1007/s00784-016-1972-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 10/05/2016] [Indexed: 01/07/2023]
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Krishnan M, Krishnan P, Chandrasekaran SC. Detection of Porphyromonas gingivalis fimA Type I Genotype in Gingivitis by Real-Time PCR-A Pilot Study. J Clin Diagn Res 2016; 10:ZC32-5. [PMID: 27504406 DOI: 10.7860/jcdr/2016/17938.7979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/23/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Published literature till date reveals a high prevalence of Porphyromonas gingivalis fimA type I genotype among healthy subjects. Quite a few studies have reported its prevalence also in periodontitis patients. Nevertheless incidence of this genotype in gingivitis is lacking in adult population. AIM The present study was chosen to detect P. gingivalis fimA type I genotype among chronic gingivitis patients. MATERIALS AND METHODS A total of 46 subgingival plaque samples collected from chronic marginal gingivitis (n=23) and chronic periodontitis subjects (control group) (n=23) were subjected to Real-Time Polymerase Chain Reaction to detect the P. gingivalis fimA type I gene. Statistical analysis was performed using chi-square test. RESULTS Prevalence of P. gingivalis fimA type I gene among chronic periodontitis and chronic gingivitis patients were 8.7% and 30.4% respectively. P. gingivalis fimA type I genotype prevalence was found to be statistically insignificant between the two study groups (p=0.135). CONCLUSION The avirulent P. gingivalis fimA type I genotype, occurred in high prevalence among chronic gingivitis patients, while its presence was low in chronic periodontitis patients. Presence of this avirulent genotype in chronic marginal gingivitis signifies its reversible condition.
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Affiliation(s)
- Mahalakshmi Krishnan
- Professor and Head, Department of Microbiology/Director, Research Lab for Oral-Systemic Health, Sree Balaji Dental College and Hospital, BIHER , Velachery - Tambaram Road, Chennai, India
| | - Padma Krishnan
- Assistant Professor, Department of Microbiology, Dr. ALM PGIBMS, University of Madras , Chennai, India
| | - S C Chandrasekaran
- Professor and Head, Department of Periodontics and Implantology, Sree Balaji Dental College and Hospital, BIHER , Velachery - Tambaram Road, Chennai, India
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Milne TJ, Coates DE, Leichter JW, Soo L, Williams SM, Seymour GJ, Cullinan MP. Periodontopathogen levels following the use of an Er:YAG laser in the treatment of chronic periodontitis. Aust Dent J 2016; 61:35-44. [DOI: 10.1111/adj.12306] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 12/23/2022]
Affiliation(s)
- TJ Milne
- Sir John Walsh Research Institute; School of Dentistry; University of Otago; Dunedin New Zealand
| | - DE Coates
- Sir John Walsh Research Institute; School of Dentistry; University of Otago; Dunedin New Zealand
| | - JW Leichter
- Sir John Walsh Research Institute; School of Dentistry; University of Otago; Dunedin New Zealand
| | - L Soo
- Sir John Walsh Research Institute; School of Dentistry; University of Otago; Dunedin New Zealand
| | - SM Williams
- Preventive and Social Medicine; Dunedin School of Medicine; University of Otago; Dunedin New Zealand
| | - GJ Seymour
- Sir John Walsh Research Institute; School of Dentistry; University of Otago; Dunedin New Zealand
| | - MP Cullinan
- Sir John Walsh Research Institute; School of Dentistry; University of Otago; Dunedin New Zealand
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Real-time PCR analysis of fungal organisms and bacterial species at peri-implantitis sites. Int J Implant Dent 2015; 1:9. [PMID: 27747631 PMCID: PMC5005605 DOI: 10.1186/s40729-015-0010-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/11/2015] [Indexed: 11/24/2022] Open
Abstract
Background The potential role of fungal organisms and their co-aggregation with either periodontopathogens or opportunistic pathogens at peri-implantitis sites is unknown. The aim of the present study was to qualitatively/quantitatively analyze and correlate fungal organisms and bacterial species at peri-implantitis sites. Methods In a total of 29 patients, submucosal/subgingival plaque samples were collected at peri-implantitis and healthy implant sites as well as teeth with a history of periodontitis (controls). A real-time PCR assay was established for the qualification of fungal organisms and a TaqMan assay for the quantification of Porphyromonas gingivalis, Parvimonas micra, Tannerella forsythia, Mycoplasma salivarium, Veillonella parvula, and Staphylococcus aureus. Results Fungal organisms were more frequently identified at peri-implantitis (31.6%) (i.e., Candida albicans, Candida boidinii, Penicillium spp., Rhodotorula laryngis, Paelicomyces spp., Saccharomycetes, Cladosporium cladosporioides) and healthy implant sites (40% - Candida dubliniensis, C. cladosporioides) than at selected teeth (20% - C. albicans, Fusarium solani). At implant sites, fungal organisms were significantly correlated with P. micra and T. forsythia. Conclusions Candida spp. and other fungal organisms were frequently identified at peri-implantitis as well as healthy implant sites and co-colonized with P. micra and T. forsythia.
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Siddiqi A, Milne T, Cullinan MP, Seymour GJ. Analysis ofP. gingivalis, T. forsythiaandS. aureuslevels in edentulous mouths prior to and 6 months after placement of one-piece zirconia and titanium implants. Clin Oral Implants Res 2014; 27:288-94. [DOI: 10.1111/clr.12536] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Allauddin Siddiqi
- Oral Implantology Research Group; Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Trudy Milne
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Mary P. Cullinan
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Gregory J. Seymour
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
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Periodontal bacteria in human carotid atherothrombosis as a potential trigger for neutrophil activation. Atherosclerosis 2014; 236:448-55. [DOI: 10.1016/j.atherosclerosis.2014.07.034] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 07/30/2014] [Accepted: 07/30/2014] [Indexed: 01/11/2023]
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20
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Guglielmetti MR, Rosa EF, Lourenção DS, Inoue G, Gomes EF, De Micheli G, Mendes FM, Hirata RD, Hirata MH, Pannuti CM. Detection and Quantification of Periodontal Pathogens in Smokers and Never-Smokers With Chronic Periodontitis by Real-Time Polymerase Chain Reaction. J Periodontol 2014; 85:1450-7. [DOI: 10.1902/jop.2014.140048] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Real-time PCR quantification of six periodontal pathogens in saliva samples from healthy young adults. Clin Oral Investig 2014; 19:937-46. [PMID: 25217278 DOI: 10.1007/s00784-014-1316-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 09/01/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The use of saliva as a diagnostic fluid for the evaluation of periodontal health has gained attention recently. Most published real-time PCR assays focused on quantification of bacteria in subgingival plaque, not in saliva. The aims of this study were to develop a real-time PCR assay for quantification of six periodontal pathogens in saliva and to establish a relationship between the amount of DNA (fg) and colony-forming unit (CFU). MATERIALS AND METHODS TaqMan primers/probe sets were used for the detection of Aggregatibacter actinomycetemcomitans (Aa), Eikenella corrodens (Ec), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythia (Tf), and total bacteria. Six periodontal pathogens and total bacteria in saliva from 24 periodontally healthy individuals were determined. The relationship between the amount of DNA (fg) and CFU was established by measuring the concentrations of extracted bacterial DNA and CFU per milliliter of bacteria on agar plates. RESULTS Fn, Ec, and Pi were detected in all saliva samples, while 58.5, 45.8, and 33.3% were detected for Tf, Pg, and Aa, respectively. Numbers of Ec and Fn in saliva were highly correlated (R(2) = 0.93, P < 0.01). The values of DNA (fg) per CFU ranged from 64 for Ec to 121 for Pg. CONCLUSION The real-time PCR assay in combination with the relationship between DNA (fg) and CFU can be used to quantitate periodontal pathogens in saliva and estimate the number of live bacteria (CFU). CLINICAL RELEVANCE This real-time PCR assay in combination with the relationship between DNA (fg) and CFU has the potential to be an adjunct in evaluation of periodontal health status.
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Göhler A, Hetzer A, Holtfreter B, Geisel MH, Schmidt CO, Steinmetz I, Kocher T. Quantitative molecular detection of putative periodontal pathogens in clinically healthy and periodontally diseased subjects. PLoS One 2014; 9:e99244. [PMID: 25029268 PMCID: PMC4100758 DOI: 10.1371/journal.pone.0099244] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 05/13/2014] [Indexed: 01/11/2023] Open
Abstract
Periodontitis is a multi-microbial oral infection with high prevalence among adults. Putative oral pathogens are commonly found in periodontally diseased individuals. However, these organisms can be also detected in the oral cavity of healthy subjects. This leads to the hypothesis, that alterations in the proportion of these organisms relative to the total amount of oral microorganisms, namely their abundance, rather than their simple presence might be important in the transition from health to disease. Therefore, we developed a quantitative molecular method to determine the abundance of various oral microorganisms and the portion of bacterial and archaeal nucleic acid relative to the total nucleic acid extracted from individual samples. We applied quantitative real-time PCRs targeting single-copy genes of periodontal bacteria and 16S-rRNA genes of Bacteria and Archaea. Testing tongue scrapings of 88 matched pairs of periodontally diseased and healthy subjects revealed a significantly higher abundance of P. gingivalis and a higher total bacterial abundance in diseased subjects. In fully adjusted models the risk of being periodontally diseased was significantly higher in subjects with high P. gingivalis and total bacterial abundance. Interestingly, we found that moderate abundances of A. actinomycetemcomitans were associated with reduced risk for periodontal disease compared to subjects with low abundances, whereas for high abundances, this protective effect leveled off. Moderate archaeal abundances were health associated compared to subjects with low abundances. In conclusion, our methodological approach unraveled associations of the oral flora with periodontal disease, which would have gone undetected if only qualitative data had been determined.
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Affiliation(s)
- André Göhler
- Friedrich Loeffler Institute of Medical Microbiology, Ernst Moritz Arndt University, Greifswald, Germany
| | - Adrian Hetzer
- Friedrich Loeffler Institute of Medical Microbiology, Ernst Moritz Arndt University, Greifswald, Germany
| | - Birte Holtfreter
- Unit of Periodontology, Dental School, University Medicine, Ernst Moritz Arndt University, Greifswald, Germany
| | - Marie Henrike Geisel
- Unit of Periodontology, Dental School, University Medicine, Ernst Moritz Arndt University, Greifswald, Germany
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Carsten Oliver Schmidt
- Section Methods in Community Medicine, Institute for Community Medicine, University Medicine Greifswald, Ernst Moritz Arndt University, Greifswald, Germany
| | - Ivo Steinmetz
- Friedrich Loeffler Institute of Medical Microbiology, Ernst Moritz Arndt University, Greifswald, Germany
- * E-mail: (IM); (TK)
| | - Thomas Kocher
- Unit of Periodontology, Dental School, University Medicine, Ernst Moritz Arndt University, Greifswald, Germany
- * E-mail: (IM); (TK)
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The periodontal pathogen Porphyromonas gingivalis induces expression of transposases and cell death of Streptococcus mitis in a biofilm model. Infect Immun 2014; 82:3374-82. [PMID: 24866802 DOI: 10.1128/iai.01976-14] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Oral microbial communities are extremely complex biofilms with high numbers of bacterial species interacting with each other (and the host) to maintain homeostasis of the system. Disturbance in the oral microbiome homeostasis can lead to either caries or periodontitis, two of the most common human diseases. Periodontitis is a polymicrobial disease caused by the coordinated action of a complex microbial community, which results in inflammation of tissues that support the teeth. It is the most common cause of tooth loss among adults in the United States, and recent studies have suggested that it may increase the risk for systemic conditions such as cardiovascular diseases. In a recent series of papers, Hajishengallis and coworkers proposed the idea of the "keystone-pathogen" where low-abundance microbial pathogens (Porphyromonas gingivalis) can orchestrate inflammatory disease by turning a benign microbial community into a dysbiotic one. The exact mechanisms by which these pathogens reorganize the healthy oral microbiome are still unknown. In the present manuscript, we present results demonstrating that P. gingivalis induces S. mitis death and DNA fragmentation in an in vitro biofilm system. Moreover, we report here the induction of expression of multiple transposases in a Streptococcus mitis biofilm when the periodontopathogen P. gingivalis is present. Based on these results, we hypothesize that P. gingivalis induces S. mitis cell death by an unknown mechanism, shaping the oral microbiome to its advantage.
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Vernon LT, Demko CA, Babineau DC, Wang X, Toossi Z, Weinberg A, Rodriguez B. Effect of Nadir CD4+ T cell count on clinical measures of periodontal disease in HIV+ adults before and during immune reconstitution on HAART. PLoS One 2013; 8:e76986. [PMID: 24146949 PMCID: PMC3795634 DOI: 10.1371/journal.pone.0076986] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 09/04/2013] [Indexed: 11/18/2022] Open
Abstract
Background The contribution of HIV-infection to periodontal disease (PD) is poorly understood. We proposed that immunological markers would be associated with improved clinical measures of PD. Methods We performed a longitudinal cohort study of HIV-infected adults who had started highly active antiretroviral therapy (HAART) <2 years. PD was characterized clinically as the percent of teeth with ≥1 site with periodontal probing depth (PPD) ≥5.0mm, recession (REC) >0mm, clinical attachment level (CAL) ≥4.0mm, and bleeding on probing (BOP) at ≥4 sites/tooth and microbiologically as specific periodontopathogen concentration. Linear mixed-effects models were used to assess the associations between immune function and PD. Results Forty (40) subjects with median 2.7 months on HAART and median nadir CD4+ T-cell count of 212 cells/μl completed a median 3 visits. Over 24 months, CD4+ T-cell count increased by a mean 173 cells/µl (p<0.001) and HIV RNA decreased by 0.5 log10 copies/ml (p<0.001); concurrently, PPD, CAL and BOP decreased by a mean 11.7%, 12.1%, and 14.7% respectively (all p<0.001). Lower nadir CD4+ T-cell count was associated with worse baseline REC (-6.72%; p=0.04) and CAL (9.06%; p<0.001). Further, lower nadir CD4+ T-cell count was associated with a greater relative longitudinal improvement in PPD in subjects with higher baseline levels of Porphyromonas gingivalis (p=0.027), and BOP in subjects with higher baseline levels of Porphyromonas gingivalis or Treponema denticola (p=0.001 and p=0.006 respectively). Longitudinal changes from baseline in CD4+ T-cell count and level of HIV RNA were not independently associated with longitudinal changes in any clinical markers of PD. Conclusion Degree of immunosuppression was associated with baseline gingival recession. After HAART initiation, measures of active PD improved most in those with lower nadir CD4+ T-cell counts and higher baseline levels of specific periodontopathogens. Nadir CD4+ T-cell count differentially influences periodontal disease both before and after HAART in HIV-infected adults.
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Affiliation(s)
- Lance T. Vernon
- Department of Biological Sciences, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, United States of America
- * E-mail:
| | - Catherine A. Demko
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, United States of America
| | - Denise C. Babineau
- Center for Clinical Investigation, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Xuelei Wang
- Center for Clinical Investigation, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Zahra Toossi
- Department of Medicine, Division of Infectious Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Aaron Weinberg
- Department of Biological Sciences, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, United States of America
| | - Benigno Rodriguez
- Center for AIDS Research, Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio, United States of America
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Aemaimanan P, Amimanan P, Taweechaisupapong S. Quantification of key periodontal pathogens in insulin-dependent type 2 diabetic and non-diabetic patients with generalized chronic periodontitis. Anaerobe 2013; 22:64-8. [PMID: 23827459 DOI: 10.1016/j.anaerobe.2013.06.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/28/2013] [Accepted: 06/23/2013] [Indexed: 10/26/2022]
Abstract
Periodontitis is a common problem in patients with diabetes mellitus (DM), however, differences in the putative periodontal pathogens in subjects with DM compared to non-DM subjects are still inconclusive. The red complex, which includes Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, encompasses the most important pathogens in adult periodontal disease. The aim of the present study was to compare cell numbers of P. gingivalis, T. denticola, T. forsythia and Aggregatibacter actinomycetemcomitans in gingival sulcus of healthy, gingivitis and periodontitis sites of non-diabetes mellitus (NDM), controlled and poorly controlled insulin-dependent DM (CDM and PDM) patients with generalized chronic periodontitis. Subgingival plaque samples were collected from 19 CDM, 19 PDM and 19 NDM patients. Taqman real time-PCR was used to determine bacterial cell number. At subject level, the quantity of red complex bacteria was significantly higher in PDM than those of NDM and positively correlated with HbA1c. At site level (total 342 sites), cell numbers of T. denticola and T. forsythia in healthy sites of CDM and PDM were significantly higher than those of NDM. In gingivitis sites, the numbers of P. gingivalis in CDM and PDM and T. forsythia in PDM were significantly higher than those of NDM while in periodontitis sites, higher quantity of P. gingivalis in PDM was observed. Our study indicated that poor glycemic control is associated with increasing cell numbers of red complex bacteria in subgingival biofilm.
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Decat E, Cosyn J, De Bruyn H, Miremadi R, Saerens B, Van Mechelen E, Vermeulen S, Vaneechoutte M, Deschaght P. Optimization of quantitative polymerase chain reactions for detection and quantification of eight periodontal bacterial pathogens. BMC Res Notes 2012. [PMID: 23199017 PMCID: PMC3532386 DOI: 10.1186/1756-0500-5-664] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The aim of this study was to optimize quantitative (real-time) polymerase chain reaction (qPCR) assays for 8 major periodontal pathogens, i.e. Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Parvimonas micros, Porphyromonas gingivalis, Prevotella intermedia, Tanerella forsythia and Treponema denticola, and of the caries pathogen Streptococcus mutans. Results Eighteen different primer pairs were analyzed in silico regarding specificity (using BLAST analysis) and the presence of secondary structures at primer binding sites (using mFOLD). The most specific and efficiently binding primer pairs, according to these analyses, were selected for qPCR-analysis to determine amplification efficiency, limit of quantification and intra-run reproducibility. For the selected primer pairs, one for each species, the specificity was confirmed by assessing amplification of DNA extracts from isolates of closely related species. For these primer pairs, the intercycler portability was evaluated on 3 different thermal cyclers (the Applied Biosystems 7300, the Bio-Rad iQ5 and the Roche Light Cycler 480). For all assays on the different cyclers, a good correlation of the standard series was obtained (i.e. r2 ≥ 0.98), but quantification limits varied among cyclers. The overall best quantification limit was obtained by using a 2 μl sample in a final volume of 10 μl on the Light Cycler 480. Conclusions In conclusion, the proposed assays allow to quantify the bacterial loads of S. mutans, 6 periodontal pathogenic species and the genus Fusobacterium.This can be of use in assessing periodontal risk, determination of the optimal periodontal therapy and evaluation of this treatment.
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Affiliation(s)
- Ellen Decat
- Biomedical and Exact Sciences, Faculty of Education, Health&Social Work, University College Ghent, Keramiekstraat 80, Ghent, Belgium.
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Rodrigues AS, Lourenção DS, Lima Neto LG, Pannuti CM, Crespo Hirata RD, Hirata MH, Lotufo RF, De Micheli G. Clinical and Microbiologic Evaluation, by Real-Time Polymerase Chain Reaction, of Non-Surgical Treatment of Aggressive Periodontitis Associated With Amoxicillin and Metronidazole. J Periodontol 2012; 83:744-52. [DOI: 10.1902/jop.2011.110333] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Effect of periodontal pathogens on the metatranscriptome of a healthy multispecies biofilm model. J Bacteriol 2012; 194:2082-95. [PMID: 22328675 DOI: 10.1128/jb.06328-11] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Oral bacterial biofilms are highly complex microbial communities with up to 700 different bacterial taxa. We report here the use of metatranscriptomic analysis to study patterns of community gene expression in a multispecies biofilm model composed of species found in healthy oral biofilms (Actinomyces naeslundii, Lactobacillus casei, Streptococcus mitis, Veillonella parvula, and Fusobacterium nucleatum) and the same biofilm plus the periodontopathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. The presence of the periodontopathogens altered patterns in gene expression, and data indicate that transcription of protein-encoding genes and small noncoding RNAs is stimulated. In the healthy biofilm hypothetical proteins, transporters and transcriptional regulators were upregulated while chaperones and cell division proteins were downregulated. However, when the pathogens were present, chaperones were highly upregulated, probably due to increased levels of stress. We also observed a significant upregulation of ABC transport systems and putative transposases. Changes in Clusters of Orthologous Groups functional categories as well as gene set enrichment analysis based on Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways showed that in the absence of pathogens, only sets of proteins related to transport and secondary metabolism were upregulated, while in the presence of pathogens, proteins related to growth and division as well as a large portion of transcription factors were upregulated. Finally, we identified several small noncoding RNAs whose predicted targets were genes differentially expressed in the open reading frame libraries. These results show the importance of pathogens controlling gene expression of a healthy oral community and the usefulness of metatranscriptomic techniques to study gene expression profiles in complex microbial community models.
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Vernon LT, Babineau DC, Demko CA, Lederman MM, Wang X, Toossi Z, Weinberg A, Rodriguez B. A prospective cohort study of periodontal disease measures and cardiovascular disease markers in HIV-infected adults. AIDS Res Hum Retroviruses 2011; 27:1157-66. [PMID: 21443451 PMCID: PMC3206743 DOI: 10.1089/aid.2010.0320] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The determinants of HIV-associated cardiovascular disease (CVD) are not well understood. Periodontal disease (PD) has been linked to CVD but this connection has not been examined in HIV infection. We followed a cohort of HIV-infected adults to ascertain whether PD was associated with carotid artery intima media thickness (IMT) and brachial artery flow-mediated dilation (FMD). We performed a longitudinal observational study of HIV-infected adults on HAART for <2 years with no known heart disease. PD was characterized clinically and microbiologically. Cardiovascular disease was assessed by IMT/FMD. Linear mixed models assessed cross-sectional and longitudinal associations between PD and FMD/IMT. Forty three HIV(+) adults completed a median of 24 (6-44) months on the study. Defining delta to be the change in a variable between baseline and a follow-up time, longitudinally, on average and after adjusting for change in time, CVD-specific and HIV-specific potential confounding covariates, a 1-log(10) increase in delta Porphyromonas gingivalis was associated with a 0.013 mm increase in delta IMT (95% CI: 0.0006-0.0262; p=0.04). After adjusting for the same potential confounding covariates, a 10% increase in delta gingival recession was associated with a 2.3% increase in delta FMD (95% CI: 0.4-4.2; p=0.03). In a cohort of HIV-infected adults, an increase in subgingival Porphyromonas gingivalis, a known periodontal pathogen, was significantly associated with longitudinal increases in IMT, while increased gingival recession, which herein may represent PD resolution, was significantly associated with longitudinal improvement in FMD. In the context of HIV infection, PD may contribute to CVD risk. Intervention studies treating PD may help clarify this association.
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Affiliation(s)
- Lance T Vernon
- Case Western Reserve University School of Dental Medicine, Department of Biological Sciences, Cleveland, Ohio 44106-4905, USA.
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Kretschmar S, Yin L, Roberts F, London R, Flemmig TT, Arushanov D, Kaiyala K, Chung WO. Protease inhibitor levels in periodontal health and disease. J Periodontal Res 2011; 47:228-35. [PMID: 22029638 DOI: 10.1111/j.1600-0765.2011.01425.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVE Our previous study showed that protease inhibitors were attenuated by the periodontal pathogen Porphyromonas gingivalis in cultured gingival epithelial cells. We hypothesize that fewer protease inhibitors would be present in more advanced periodontal disease sites, where the level of P. gingivalis may be high. The goal of this study was to investigate the relationship between the protease inhibitor [secretory leukocyte protease inhibitor (SLPI), elastase-specific inhibitor (ELAFIN) and squamous cell carcinoma antigen (SCCA)] levels in gingival crevicular fluid and the number of P. gingivalis micro-organisms in subgingival plaque. MATERIAL AND METHODS Plaque samples from subjects without (n = 18) and with moderate to advanced periodontitis (n = 41) were used to quantify P. gingivalis using real-time PCR. Protease inhibitor levels in the gingival crevicular fluid of all the subjects were determined by ELISA. RESULTS P. gingivalis was detected in 68.3% of patients with periodontitis, while 16.7% of subjects without periodontitis had a detectable level of P. gingivalis. Patients with periodontitis and P. gingivalis in their plaque exhibited lower SLPI and ELAFIN levels (p < 0.001) compared with control subjects without periodontitis. Secretory leukocyte protease inhibitor was also reduced (p < 0.05) in gingival crevicular fluid of periodontitis patients without a detectable level of P. gingivalis. Periodontitis patients with high vs. low levels of P. gingivalis exhibited reciprocal mean levels of SLPI and ELAFIN concentrations. CONCLUSION The reduced concentrations of SLPI and ELAFIN may contribute to the loss of host protective capacity and increase susceptibility to breakdown from chronic infection. The work of this investigation may aid in finding diagnostic and prognostic markers in periodontal health and disease and may also help in finding pharmacological targets directed against periodontal inflammation.
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Affiliation(s)
- S Kretschmar
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
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Real-time Polymerase Chain Reaction Quantification of Porphyromonas gingivalis and Tannerella forsythia in Primary Endodontic Infections. J Endod 2009; 35:1518-24. [DOI: 10.1016/j.joen.2009.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 08/03/2009] [Accepted: 08/05/2009] [Indexed: 11/24/2022]
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Vernon LT, Demko CA, Whalen CC, Lederman MM, Toossi Z, Wu M, Han YW, Weinberg A. Characterizing traditionally defined periodontal disease in HIV+ adults. Community Dent Oral Epidemiol 2009; 37:427-37. [PMID: 19624697 DOI: 10.1111/j.1600-0528.2009.00485.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Results have varied from previous studies examining the level and extent of periodontal disease (PD) in HIV-1 infected (HIV+) adults. These studies used different methodologies to measure and define PD and examined cohorts with divergent characteristics. Inconsistent methodological approaches may have resulted in the underestimation of traditionally-defined PD in HIV+ individuals. OBJECTIVES To characterize the level, extent and predictors (i.e. immunologic, microbiologic, metabolic and behavioral) of PD in an HIV+ cohort during the era of highly active antiretroviral therapy (HAART). STUDY DESIGN Cross-sectional study. SETTING HIV+ adults receiving outpatient care at three major medical clinics in Cleveland, OH. Subjects were seen from May, 2005 to January, 2008. MEASUREMENTS Full-mouth periodontal examinations included periodontal probing depth (PPD), recession (REC) and clinical attachment level (CAL). Subgingival plaque was assessed for DNA levels of Porphyromonas gingivalis (Pg), Tannerella forsythia, and Treponema denticola by real-time DNA PCR assays developed for each pathogen. Rather than using categories, we evaluated PD as three continuous variables based on the percent of teeth with >or=1 site per tooth with PPD >or= 5mm, REC > 0 mm and CAL >or= 4mm. RESULTS Participants included 112 HIV+ adults. Each subject had an average 38% (+/-24%) of their teeth with at least one site of PD >or= 5 mm, 55% (+/-31%) of their teeth with at least one site of REC > 0 mm, and 50% (+/-32%) of their teeth with at least one site of CAL >or= 4 mm. CD4+ T-cell count <200 cells/mm(3) was significantly associated with higher levels of REC and CAL, but not PPD. Greater levels of Pg DNA were associated with PPD, REC and CAL.By regression analysis, CD4+ T-cell count <200 cells /mm3 had approximately twice thedeleterious effect on CAL as did smoking (standardized beta coefficient 0.306 versus 0.164) [corrected]. Annual dental visit compliance remained an independent predictor for lower levels of PD. CONCLUSIONS The level and extent of PD were high in this cohort even though most patients were being treated with HAART. The definition of periodontal disease used and cohort characteristics examined can influence the level of periodontal disease reported in studies of persons with HIV. Traditional periodontal pathogens are associated with PD in this cohort. Those with CD4+ T-cell counts <200 cells/mm(3) are at greater risk for PD. Therefore, earlier HAART initiation may decrease exposure to immunosuppression and reduce PD morbidity. Continuity of dental care remains important for HIV+ patients even when they are being treated with HAART.
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Affiliation(s)
- Lance T Vernon
- Department of Biological Sciences, Case Western Reserve University (CWRU), School of Dental Medicine, Cleveland, OH 44106-4905, USA.
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Hyvärinen K, Laitinen S, Paju S, Hakala A, Suominen-Taipale L, Skurnik M, Könönen E, Pussinen PJ. Detection and quantification of five major periodontal pathogens by single copy gene-based real-time PCR. Innate Immun 2009; 15:195-204. [PMID: 19586997 DOI: 10.1177/1753425908101920] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Periodontitis is a common chronic multibacterial infection in the tooth-supporting tissues. It has been shown that periodontitis patients carry higher number of disease-associated bacteria than healthy ones. The aim of this study was to generate a novel, single copy gene-based quantitative real-time PCR (qPCR) assay for five major periodontal pathogens - Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola, and Tannerella forsythia. The primer/probe sets were designed for conservative lipopolysaccharide-coding gene regions. They proved to be sensitive and able to detect strains representing different serotypes of the target bacteria. The specificity of designed primers was tested using 49 selected bacterial species and no false positive or negative results were observed. We validated the assay with a case-control population, including 165 saliva samples, and proved the diagnostic accuracy by Receiver Operating Characteristic (ROC) curves. All quantified pathogens alone were able to distinguish significantly between the subjects with and without periodontitis, and provided areas under the ROC curve larger than 0.5. The total pathogen burden comprising all five species associated with periodontitis with an area of 0.821 (95% CI, 0.758-0.885, P50.001). Our prominently sensitive and specific assay may have major importance in the diagnosis, prevention, and treatment of periodontitis.
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Affiliation(s)
- Kati Hyvärinen
- Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland.
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Gomes SC, Nonnenmacher C, Susin C, Oppermann RV, Mutters R, Marcantonio RA. The Effect of a Supragingival Plaque-Control Regimen on the Subgingival Microbiota in Smokers and Never-Smokers: Evaluation by Real-Time Polymerase Chain Reaction. J Periodontol 2008; 79:2297-304. [DOI: 10.1902/jop.2008.070558] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Atieh MA. Accuracy of Real-Time Polymerase Chain Reaction Versus Anaerobic Culture in Detection ofAggregatibacter actinomycetemcomitans andPorphyromonas gingivalis: A Meta-Analysis. J Periodontol 2008; 79:1620-9. [DOI: 10.1902/jop.2008.070668] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kirakodu SS, Govindaswami M, Novak MJ, Ebersole JL, Novak KF. Optimizing qPCR for the Quantification of Periodontal Pathogens in a Complex Plaque Biofilm. Open Dent J 2008; 2:49-55. [PMID: 19088882 PMCID: PMC2581537 DOI: 10.2174/1874210600802010049] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Accepted: 02/04/2008] [Indexed: 11/30/2022] Open
Abstract
Quantitative PCR (qPCR) has recently been used to quantify microorganisms in complex communities, including dental plaque biofilms. However, there is variability in the qPCR protocols being used. This study was designed to evaluate the validity of two of these variables with the intent of developing a more standardized qPCR protocol. The two variables evaluated were (1) the use of DNA content versus actual cell counts to estimate bacterial numbers in mixed plaque samples and (2) the effectiveness of three different universal primers versus species specific primers in amplifying specific target pathogens in these samples. Results lead to the development of a standardized protocol that was shown to be highly reproducible as demonstrated by low coefficients of variation. The results also confirmed that this standardized qPCR protocol can be used as a sensitive method for quantifying specific bacterial species in human plaque samples.
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Affiliation(s)
- S S Kirakodu
- Center for Oral Health Research, College of Dentistry, University of Kentucky College of Dentistry, Lexington, USA
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Haffajee AD, Teles RP, Socransky SS. Association of Eubacterium nodatum and Treponema denticola with human periodontitis lesions. ACTA ACUST UNITED AC 2006; 21:269-82. [PMID: 16922925 DOI: 10.1111/j.1399-302x.2006.00287.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The purpose of the present investigation was to compare the levels, proportions and percentage of sites colonized by 40 bacterial species in subgingival plaque samples from periodontally healthy subjects and patients with chronic periodontitis to seek possible pathogens other than the consensus pathogens Porphyromonas gingivalis and Tannerella forsythia. METHOD Subgingival plaque samples were taken from the mesial aspect of each tooth in 635 subjects with chronic periodontitis and 189 periodontally healthy subjects. The samples were individually analyzed for their content of 40 bacterial species using checkerboard DNA-DNA hybridization (total samples = 21,832). Mean counts, % DNA probe counts and percentage of sites colonized at >10(5) were determined for each species in each subject and then averaged in each clinical group. Significance of difference between groups was determined using the Mann-Whitney test. Association between combinations of species and periodontal status was examined by stepwise logistic regression analysis. Analyses were repeated using a subset of subjects from both clinical groups who had proportions of P. gingivalis plus T. forsythia less than the median (4.42%) found in periodontally healthy subjects. All analyses were adjusted for multiple comparisons. RESULTS For the 824 subjects the consensus pathogens P. gingivalis and T. forsythia as well as Eubacterium nodatum and Treponema denticola had significantly higher mean counts, proportions and percentage of sites colonized in samples from subjects with periodontitis than from periodontally healthy subjects. There were significantly more Capnocytophaga gingivalis, Streptococcus gordonii and Veillonella parvula in periodontally healthy subjects. E. nodatum, T. denticola, Streptococcus oralis, Streptococcus intermedius, Fusobacterium nucleatum ssp. vincentii all had higher counts and proportions in diseased than healthy subjects who had low proportions of P. gingivalis and T. forsythia. Logistic regression analysis indicated that the same species groups were associated with disease status after adjusting for the proportions of the other species. CONCLUSIONS This investigation confirmed the strong association of P. gingivalis and T. forsythia with chronic periodontitis and emphasized a strong association of E. nodatum and T. denticola with periodontitis whether in the presence or absence of high levels of the consensus pathogens. Other species, including S. oralis, Eikenella corrodens, S. intermedius and F. nucleatum ssp. vincentii, were associated with disease when P. gingivalis and T. forsythia were present in low proportions.
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Affiliation(s)
- A D Haffajee
- Department of Periodontology, The Forsyth Institute, 140 The Fenway, Boston, MA 02115, USA.
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38
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Affiliation(s)
- Ricardo P Teles
- Department of Periodontology, The Forsyth Institute, Boston, Massachusetts, USA
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Orrù G, Marini MF, Ciusa ML, Isola D, Cotti M, Baldoni M, Piras V, Pisano E, Montaldo C. Usefulness of real time PCR for the differentiation and quantification of 652 and JP2 Actinobacillus actinomycetemcomitans genotypes in dental plaque and saliva. BMC Infect Dis 2006; 6:98. [PMID: 16772039 PMCID: PMC1539009 DOI: 10.1186/1471-2334-6-98] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2006] [Accepted: 06/13/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of our study is to describe a fast molecular method, able to distinguish and quantize the two different genotypes (652 and JP2) of an important periodontal pathogen: Actinobacillus actinomycetemcomitans. The two genotypes show differences in the expression of an important pathogenic factor: the leukotoxin (ltx). In order to evidence this, we performed a real time PCR procedure on the ltx operon, able to recognize Aa clinical isolates with different leukotoxic potentials. METHODS The specificity of the method was confirmed in subgingival plaque and saliva specimens collected from eighty-one Italian (Sardinian) subjects with a mean age of 43.9, fifty five (68 %) of whom had various clinical forms of periodontal disease. RESULTS This procedure showed a good sensitivity and a high linear dynamic range of quantization (10(7)-10(2) cells/ml) for all genotypes and a good correlation factor (R2 = 0.97-0.98). Compared with traditional cultural methods, this real time PCR procedure is more sensitive; in fact in two subgingival plaque and two positive saliva specimens Aa was only detected with the molecular method. CONCLUSION A low number of Sardinian patients was found positive for Aa infections in the oral cavity, (just 10 positive periodontal cases out of 81 and two of these were also saliva positive). The highly leukotoxic JP2 strain was the most representative (60 % of the positive specimens); the samples from periodontal pockets and from saliva showed some ltx genotype for the same patient. Our experience suggests that this approach is suitable for a rapid and complete laboratory diagnosis for Aa infection.
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Affiliation(s)
- Germano Orrù
- O.B.L. (Oral Biotechnology Laboratory), Dipartimento di Chirurgia e Odontostomatologia Università degli Studi di Cagliari, Cagliari, Italy
| | - Mario Francesco Marini
- O.B.L. (Oral Biotechnology Laboratory), Dipartimento di Chirurgia e Odontostomatologia Università degli Studi di Cagliari, Cagliari, Italy
- Universita' degli Studi Milano Bicocca, Dipartimento di Neuroscienze, Dottorato di Ricerca in Parodontologia Sperimentale, Milano, Italy
| | - Maria Laura Ciusa
- O.B.L. (Oral Biotechnology Laboratory), Dipartimento di Chirurgia e Odontostomatologia Università degli Studi di Cagliari, Cagliari, Italy
| | - Daniela Isola
- O.B.L. (Oral Biotechnology Laboratory), Dipartimento di Chirurgia e Odontostomatologia Università degli Studi di Cagliari, Cagliari, Italy
| | - Marina Cotti
- O.B.L. (Oral Biotechnology Laboratory), Dipartimento di Chirurgia e Odontostomatologia Università degli Studi di Cagliari, Cagliari, Italy
| | - Marco Baldoni
- Universita' degli Studi Milano Bicocca, Dipartimento di Neuroscienze, Dottorato di Ricerca in Parodontologia Sperimentale, Milano, Italy
| | - Vincenzo Piras
- O.B.L. (Oral Biotechnology Laboratory), Dipartimento di Chirurgia e Odontostomatologia Università degli Studi di Cagliari, Cagliari, Italy
| | - Elisabetta Pisano
- O.B.L. (Oral Biotechnology Laboratory), Dipartimento di Chirurgia e Odontostomatologia Università degli Studi di Cagliari, Cagliari, Italy
| | - Caterina Montaldo
- O.B.L. (Oral Biotechnology Laboratory), Dipartimento di Chirurgia e Odontostomatologia Università degli Studi di Cagliari, Cagliari, Italy
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Abstract
Oral infectious diseases, including dental caries, various forms of periodontitis and oral malodor, are not caused by a single pathogen. The etiology of these diseases is known to be associated with bacterial accumulation and plaque composition on the hard and soft tissues of the oral cavity. Therefore, the quantitative, as well as qualitative, analysis of the microorganisms present in oral biofilms, namely dental plaque, subgingival plaque and tongue debris, is important for diagnosis and rational treatment decisions. The quantitative microbial analysis of oral multi-species biofilms also provides useful information for establishing the etiology of oral infectious diseases. Recently, a 5' fluorogenic, nuclease-based, real-time polymerase chain reaction (PCR) technique has been increasingly employed for the quantitative microbial assessment of the human oral cavity. We review the development and use of TaqMan real-time PCR for quantifying oral bacteria, its role in the diagnosis of oral infectious diseases and their microbial etiology.
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Affiliation(s)
- Nao Suzuki
- Department of Preventive Dentistry, Kyushu University Faculty of Dental Science, Fukuoka 812-8582, Japan
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