The Red and Orange Complex Subgingival Microbiome of Cognitive Impairment and Cognitively Normal Elderly with Periodontitis

Increasing evidence has shown an association between periodontitis and cognitive impairment. Subgingival microbiota play a great role in periodontitis pathogenesis. However, the correlation between the subgingival microbiome and cognitive impairment remains unclear. This study aimed to evaluate the red and orange complex subgingival microbiome of cognitively impaired and cognitively normal elderly Indonesian subjects with periodontitis. Twenty-eight elderly subjects diagnosed with periodontitis underwent two cognitive examinations using the Hopkins Verbal Learning Test and the Mini-Mental State Examination. Gingival crevicular fluid taken from the periodontal pocket, at a depth between 5 and 7 mm, using a paper point was used as the subgingival samples. The subgingival microbiome in the cognitive impairment group (n = 14) and cognitively normal group (n = 14) was compared using the 16S rRNA Metagenomic iSeq™ 100 Sequencing System. There was β-diversity in the subgingival microbiota between the cognitively impaired and cognitively normal subjects. The metagenomic analysis showed a higher abundance of Porphyromonas and Treponema bacteria in the cognitive impairment group than in the normal cognitive group (p < 0.05). The abundance of Porphyromonas gingivalis and Treponema denticola was higher in the cognitively impaired elderly subjects. The role of P. gingivalis and T. denticola in the pathogenesis of cognitive impairment needs further investigation.

Estimation of periodontal pocket surface area in small to medium dogs: a proof-of-concept study

Background Periodontal disease is the most common dental disease in dogs. Although the systemic effects of periodontal disease have not been clarified in veterinary science, it is necessary to evaluate the effects of periodontal disease in clinical trials in the future. There have been a few clinical attempts made, however, to assess the severity of periodontal inflammation and its impact on the systemic health of dogs. Meanwhile, in the field of dentistry for humans, the periodontal inflamed surface area (PISA) and periodontal epithelial surface area (PESA) have been used to quantitatively assess the degree of periodontal disease affecting a single tooth as well as the overall extent of periodontitis. Recent studies have also suggested the use of these assessments to examine the relationship between periodontal inflammation and systemic health. Results The estimation formula for a dog’s periodontal pocket surface area (PPSA), an alternative to PISA and PESA in humans, was established using body weight and periodontal pocket depth. Actual values were measured using extracted teeth from various dog breeds and sizes (2.3–25.0 kg of body weight) to obtain universal regression equations for PPSA. Altogether, 625 teeth from 73 dogs of 16 breeds were extracted and subsequently analyzed for morphological information. PPSA was measured in 61 dogs of 10 breeds with periodontal disease using the established estimation formulas, and the correlation between PPSA and preoperative blood chemistry data was analyzed accordingly. A strong correlation was found between PPSA and serum globulin (r = 0.71) while moderate correlations were found for C-reactive protein (r = 0.54) and serum albumin (r = -0.51). Conclusions Estimation formulas using body weight and the 6-point probing depth were established for determining PPSA. Direct correlations between PPSA and several blood test results were observed in the study sample. Taken together, these results suggest that PPSA could be useful for evaluating the effects of periodontitis on systemic conditions in dogs.

Stumbling upon Palatogingival Groove: A Case Report

Palatogingival grooves (PGG) are developmental malformations infamous for precipitating endodontic-periodontal lesions. Pertaining to their discreet occurrence, variation in groove depth and funnel like shape, adherence of plaque and calculus is apparent thereby jeopardizing the periodontium and pulp. A case of palatogingival groove in maxillary left lateral incisor was diagnosed and managed with endodontic treatment followed by open flap debridement to seal the groove with biodentine and fill the defect with bone graft. On follow up, the periapical lesion and the periodontal pocket were successfully resolved.

Microbiological landscape of the periodontal pocket in inflammatory diseases in the periodontal tissues

Relevance. The study of the microbiological composition of periodontal pockets in inflammatory diseases of periodontal tissues is of great importance directly for the effective treatment and understanding of the pathogenetic stages of these diseases. Objective: to study the microbiological landscape of periodontal pockets with inflammatory diseases of periodontal tissues. Materials and Methods. 62 patients aged 20 to 45 years were selected and divided into groups depending on the form of periodontitis: with localized aggressive periodontitis - group №1, group №2 - with chronic generalized periodontitis, group № 3 - with exacerbation of chronic generalized periodontitis. The material for the study was taken from the periodontal pockets and examined by cultural and microbiological methods. Results and Discussion. It was found that the proportion and number of microbial associations in the periodontal pockets of different depths differs. In localized aggressive periodontitis, mainly facultative Gr+ (A. actinomycetemcomitans) and Gr- (St. aureus, Str. mitis) anaerobes were found in the periodontal pockets no more than 4 mm. In generalized chronic periodontitis of moderate degree, the same microorganisms were present in the periodontal pockets as in the localized form, but Str. mitis was more common among facultative aerobes. With the exacerbation of generalized chronic periodontitis from facultative anaerobes, St. aureus was more common and the proportion and number of A. actinomycetemcomitans significantly increased. Conclusion. According to the results of the study, the microorganisms that inhabit the periodontal pockets in inflammatory diseases of periodontal tissues mainly belong to facultative Gr+ and Gr - anaerobes, obligate Gr+ and Gr-anaerobes and yeast fungi.

lncRNA FGD5-AS1 and miR-130a Can Be Used for Prognosis Analysis of Patients with Chronic Periodontitis

Background. lncRNA and microRNA affect the occurrence and development of many diseases, so they are expected to become diagnostic or predictive indicators. But the relationship between lncRNA FGD5-AS1 and miR-130a and the prognosis of chronic periodontitis is still unclear. The purpose of this study is to explore the prognostic value of the two in chronic periodontitis. Objective. This study set out to investigate the prognostic value of lncRNA FGD5-AS1 and miR-130a in chronic periodontitis. Methods. Eighty-seven patients with chronic periodontitis who visited our hospital from March 2016 to August 2017 were collected as an observation group (OG), and 72 subjects with periodontal health who underwent physical examination at the same time were collected as a control group (CG). The FGD5-AS1 and miR-130a expression levels of subjects in the two groups were compared, and prognosis of 87 patients who were reviewed one year later was counted. The expression levels of patients with different prognoses were compared when they were admitted to our hospital. We drew the ROC curve and explored the prognostic value of FGD5-AS1 and miR-130a. The risk factors for adverse prognosis were analyzed through logistic regression. Results. FGD5-AS1 was lowly expressed in patients, while miR-130a was highly expressed. FGD5-AS1 and miR-130a had certain diagnostic and predictive value in chronic periodontitis and patient prognosis. The higher the periodontal pocket, the higher the attachment loss. Lower FGD5-AS1 and higher miR-130a levels were independent prognostic risk factors. Conclusion. lncRNA FGD5-AS1 is lowly expressed in patients with chronic periodontitis, while miR-130a is highly expressed. Both of them have certain diagnostic and prognostic value in chronic periodontitis and may be potential diagnostic and prognostic indicators.

DECREASE OF β-DEFENSIN-2 LEVEL IN THE GINGIVAL CREVICULAR FLUID AS A POTENTIAL PREDICTOR OF THE DEVELOPMENT OF INFLAMMATORY PERIODONTAL DISEASES

β-defensin-2 (HBD-2) is a peptide of innate immunity that provides the first line of defenсe of the oral mucosa from the introduction of the pathobionts. Under inflammatory conditions epithelial cells and gingival fibroblasts produce HBD-2. The defective defensin secretion may play a crucial role in the development of inflammatory periodontal diseases. The study aimed to compare the levels of HBD-2 in the gingival fluid and/or the content of the periodontal pockets in patients with dental plaque-induced gingivitis (PG), aggressive periodontitis (AgP), chronic generalized periodontitis (CP) and in the periodontally healthy subjects (Control). We examined 142 patients (45.0 ± 1.03 years) from Moscow, including 11 patients with PG (35.7 ± 3.69 years), 43 patients with AgP (35.4 ± 0.84 years), 71 patients with CP (54.4 ± 0.86 years) and 17 controls (36.1 ± 2.92 years). We determined the periodontal tissues condition in all patients during the periodontal and X-ray examination. The samples of the gingival crevicular fluid and periodontal pocket content were collected by paper points from the gingival sulcus and periodontal pockets at 8 teeth of both jaws. The concentration (C) of β-defensin-2 was determined by enzyme immunoassay (ELISA Kit for Defensin Beta 2, Cloud-Clone Corp., USA). Mann-Whitney U-test (U), the Kruskal-Wallis test (H) and the Dwass-Steel-Critchlow-Fligner post hoc test (W) determined the difference significance between the parameters. We estimated the parameter relationship and its strength using the Spearmanʼs rank correlation coefficient (rS). The critical significance level was p ≤ 0.05.The present study showed that the progression of the periodontal inflammation is accompanied by a sharp decrease in the concentration of HBD-2 in patients’ samples (H = 42.8, df =3, p < 0.001). Thus, the concentration of HBD-2 in the gingival crevicular fluid of the periodontally healthy subjects (control group) ranged from 225 to 1720 pg/ml (C = 738 [477; 1114] pg/ml). In patients with PG the median value of the peptide concentration was 242 [42.5; 610] pg/ml (Cmin = 19 pg/ml, Cmax = 1000 pg/ml). In patients with periodontitis it dropped to critically low levels: CAgP = 54 [3; 195] pg/ml (Cmin = 0, Cmax = 478 pg/ml) and ССP = 25.5 [0; 125] pg/ml (Cmin = 0, Cmax = 298 pg/ml). Thus, we can consider the level of HBD-2 in the gingival crevicular fluid – a potential predictor of the development of inflammatory periodontal diseases.

Study of the correlation between the clinical manifestations of the inflammatory periodontal diseases and the microbiome of periodontal pathogenic microflora in young representatives of a mixed population of the European region

The age of inflammatory periodontal disease (PD) manifestations has tended to decrease over the past decades. The study of the range of periodontal pathogens in young people and their influence on the PD manifestation contributes to the predictor identification for the early prevention of this pathology.The aim was to study the correlation between the range of periodontal pathogens in the dentoalveolar sulcus/periodontal pocket (DS/PC) contents and the clinical PD manifestations in young people.We examined 28 patients (23.1 ± 0.93 years) with dental biofilm-induced gingivitis (BG), 24 patients (30.7 ± 0.6 years) with aggressive periodontitis (AgP), and 87 clinically periodontally healthy patients (21.1 ± 0.49 years) (Control). The hygiene index and the periodontal status were determined in all patients. DNA of five periodontal pathogens was identified by PCR in the DS/PC contents. The statistical analysis was performed in Statistica 13.3. The critical significance level was p ≤ 0.05.DNA was not observed in 60.9 % of the control group samples and 7.1 % of the BG group samples. In other cases, the bacteria were found separately and as part of bacterial complexes. P.g. and T.f. were most often detected in all groups. P.g. (U = 474, р < 0.01) and A.a. (U = 209, р >< 0.05) significantly contributed to the plaque formation in the control group, T.d. – in BG and AgP groups (U = 37.5, р >< 0.05 and U = 34, р >< 0.05, respectively). In the AgP group, purulent discharge was more often recorded if T.d. was detected in the PC contents (χ2 = 5.53, р >< 0.05). T.f. + P.i. and P.g. + T.f. + P.i. complexes were exclusively associated with PD. Complexes of four bacteria were found only in the AgP group. The association of periodontal pathogens and their complexes with different PD forms was revealed.>< 0.01) and A.a. (U = 209, р <0.05) significantly contributed to the plaque formation in the control group, T.d. – in BG and AgP groups (U = 37.5, р <0.05 and U = 34, р <0.05, respectively). In the AgP group, purulent discharge was more often recorded if T.d. was detected in the PC contents (χ2 = 5.53, р <0.05). T.f. + P.i. and P.g. + T.f. + P.i. complexes were exclusively associated with PD. Complexes of four bacteria were found only in the AgP group.The association of periodontal pathogens and their complexes with different PD forms was revealed.

ANALYSIS OF THE CONTENTS OF THE PERIODONTAL POCKET IN CHRONIC PERIODONTITIS

Микрофлора человека - сложная саморегулирующая система, способная восстанавливаться при грамотной коррекции. Исследования последних лет показали, что нарушение нормального микробиоценоза полости рта растет из года в год и у жителей Российской Федерации превышает 90 %, вызывая при этом воспалительные заболевания в тканях пародонта, и, как правило, сопровождается дисбиозом полости рта, выраженность которого соответствует степени поражения пародонта. Одно из ведущих мест в развитии данной патологии занимает резидентная облигатно-анаэробная и микроаэрофильная микрофлора полости рта. Изучение микробиологического состава пародонтальных карманов (ПК) при воспалительных заболеваниях тканей пародонта (ВЗТП) имеет большое значение непосредственно для эффективного лечения и понимания патогенетических этапов этих заболеваний. Достаточно серьезной проблемой современной стоматологии как в нашей стране, так и за рубежом являются заболевания пародонта. Указанная патология снижает принятый ВОЗ критерий качества жизни и приводит к преждевременной потере зубов и представляет серьезную медицинскую, социальную и экономическую проблему. Первичным фактором, вызывающим поражение пародонта, являются бактерии зубного налета. Этиологическая структура инфекционных процессов в последнее десятилетие значительно изменилась, что связано с постоянной эволюцией микробов и вовлечением в патологический процесс условно-патогенных микробов, которые могут выступать в качестве комменсалов в составе нормальной микрофлоры и проявлять свою патогенность при снижении иммунного статуса организма The human microflora is a complex self-regulating system that can be restored with proper correction. Recent studies have shown that the violation of the normal microbiocenosis of the oral cavity increases from year to year and in the residents of the Russian Federation exceeds 90 %, causing inflammatory diseases in the periodontal tissues, and, as a rule, is accompanied by dysbiosis of the oral cavity, the severity of which corresponds to the degree of periodontal damage. One of the leading places in the development of this pathology is occupied by the resident obligate-anaerobic and microaerophilic microflora of the oral cavity. The study of the microbiological composition of periodontal pockets (PC) in inflammatory diseases of periodontal tissues (VSTP) is of great importance directly for the effective treatment and understanding of the pathogenetic stages of these diseases. Quite a serious problem of modern dentistry both in our country and abroad are periodontal diseases. This pathology reduces the WHO-accepted quality of life criterion and leads to premature tooth loss, and is a serious medical, social and economic problem. The primary factor that causes periodontal disease is plaque bacteria. The etiological structure of infectious processes has changed significantly in the last decade, which is due to the constant evolution of microbes and the involvement of conditionally pathogenic microbes in the pathological process, which can act as commensals in the normal microflora and show their pathogenicity with a decrease in the immune status of the body

Periodontal clinical features of bronchial asthma patient using inhalation drugs

Introduction: Bronchial asthma patients use inhalation drugs as therapy to achieve a controlled asthma state. Inhaled corticosteroids and β2 agonists are the medication that is being used in this case. Prolonged use of inhalation drugs will affect the health of periodontal tissue. The effect of these drugs can reduce the periodontal defense mechanism and increase the risk of periodontal disease. This study aims to determine the periodontal clinical features of bronchial asthma patients using inhalation drugs. Method: This research was a descriptive study. The sample of the study were 22 females and 8 males bronchial asthma patients at the Community Lung Health Center of Bandung (Balai Besar Kesehatan Paru Masyarakat Bandung/BBKPM Bandung) who had been using inhalation drugs for at least one year. The periodontal clinical feature was assessed by employing a Community Periodontal Index (CPI) modified with probing the gingival sulcus to assess the presence of gingival bleeding, periodontal pocket, and loss of clinical attachment where then a periodontal status was obtained. The periodontal status data were then processed using the periodontitis case definitions from the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) to determine periodontal disease in asthmatics patients. Results: Clinical features of gingival bleeding were found in 26 asthmatic patients (86.7%), periodontal pockets in 18 asthmatic patients (60%), and loss of clinical attachment in 27 asthmatic patients (90%). Based on the CDC/AAP case definition, 23 asthmatic patients (76.7%) had periodontitis. Bronchial asthma patients who used inhalation drugs had a risk of periodontitis.Conclusion: Bronchial asthma patients who used inhalation drugs for at least one year had gingival bleeding and loss of clinical attachment and periodontal pocket.

Polymicrobial synergy stimulates Porphyromonas gingivalis survival and gingipain expression in a multi-species subgingival community

Background Dysbiosis in subgingival microbial communities, resulting from increased inflammatory transudate from the gingival tissues, is an important factor in initiation and development of periodontitis. Dysbiotic communities are characterized by increased numbers of bacteria that exploit the serum-like transudate for nutrients, giving rise to a proteolytic community phenotype. Here we investigate the contribution of interactions between members of a sub-gingival community to survival and development of virulence in a serum environment—modelling that in the subgingival pocket. Methods Growth and proteolytic activity of three Porphyromonas gingivalis strains in nutrient broth or a serum environment were assessed using A600 and a fluorescent protease substrate, respectively. Adherence of P. gingivalis strains to serum-coated surfaces was studied with confocal microscopy and 2D-gel electrophoresis of bacterial supernatants used to investigate extracellular proteins. A model multi-species sub-gingival community containing Fusobacterium nucleatum, Streptococcus constellatus, Parvimonas micra with wild type or isogenic mutants of P. gingivalis was then created and growth and proteolytic activity in serum assessed as above. Community composition over time was monitored using culture techniques and qPCR. Results The P. gingivalis strains showed different growth rates in nutrient broth related to the level of proteolytic activity (largely gingipains) in the cultures. Despite being able to adhere to serum-coated surfaces, none of the strains was able to grow alone in a serum environment. Together in the subgingival consortium however, all the included species were able to grow in the serum environment and the community adopted a proteolytic phenotype. Inclusion of P. gingivalis strains lacking gingipains in the consortium revealed that community growth was facilitated by Rgp gingipain from P. gingivalis. Conclusions In the multi-species consortium, growth was facilitated by the wild-type and Rgp-expressing strains of P. gingivalis, suggesting that Rgp is involved in delivery of nutrients to the whole community through degradation of complex protein substrates in serum. Whereas they are constitutively expressed by P. gingivalis in nutrient broth, gingipain expression in the model periodontal pocket environment (serum) appeared to be orchestrated through signaling to P. gingivalis from other members of the community, a phenomenon which then promoted growth of the whole community.