Abstract
ObjectiveThis systematic review was to assess the presence of Trichomonas tenax in patients with periodontitis and to elucidate its potential role in the onset and development of this disease.MethodSystematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and by consulting the five databases: Medline, Science Direct, Web of Science, Dentistry and Oral Science Sources and Cochrane Central Register of Controlled Trials. Following Koch’s postulates revisited by Socransky as PICO framework, this collection data was only including full text of clinical trials concerning patients with periodontitis, case-reports and in vitro research published between 1960 and March 2019.ResultsOn the 376 studies identified, only 25 fulfilled our eligible criteria. Most of these studies were in vitro research articles designed to evaluate potential virulence factors, and others were clinical trials (case-control studies, randomized controlled trial) and case-reports. The analysis of these papers has shown that i) Trichomonas tenax is more frequently detected in dental biofilm from sites with periodontitis than in healthy sites; ii) this live flagellate seems capable of producing diverse enzymes that could participate in periodontal breakdown and has the capacity to adhere to epithelial cells, its lysed form could induce the synthesis of IL-8 from macrophage cell lines; iii) the impact of non-surgical treatment of periodontitis have not been thoroughly evaluated on the presence of T. tenaxConclusionsThis systematic review has reported the presence of T. tenax more frequently in diseased than healthy sites and the capacity of this flagellate to synthesis enzymes which could participate to the degradation of periodontal tissues. Nevertheless, these data do not meet all the postulates and are not enough to provide firm conclusions about the role of T. tenax in the etiopathogenesis of periodontitis.
Highlights
The global burden of oral disorders and their associated sequelae have been assessed at various dates (1990, 2005 and 2010) by Marcenes et al [1]
On the 376 studies identified, only 25 fulfilled our eligible criteria. Most of these studies were in vitro research articles designed to evaluate potential virulence factors, and others were clinical trials and case-reports. The analysis of these papers has shown that i) Trichomonas tenax is more frequently detected in dental biofilm from sites with periodontitis than in healthy sites; ii) this live flagellate seems capable of producing diverse enzymes that could participate in periodontal breakdown and has the capacity to adhere to epithelial cells, its lysed form could induce the synthesis of IL-8 from macrophage cell lines; iii) the impact of non-surgical treatment of periodontitis have not been thoroughly evaluated on the presence of T. tenax
This systematic review has reported the presence of T. tenax more frequently in diseased than healthy sites and the capacity of this flagellate to synthesis enzymes which could participate to the degradation of periodontal tissues
Summary
The global burden of oral disorders and their associated sequelae have been assessed at various dates (1990, 2005 and 2010) by Marcenes et al [1]. These authors concluded that DALYS (Disability-Adjusted Life Years) induced by oral conditions had increased by 20.8% between 1990 and 2010 due to population growth, the ageing process and severe periodontitis. Periodontitis is recognized as an inflammatory disease, mainly induced by pathobionts such as Porphyromonas gingivalis in synergy with other putative pathogens present in a complex and diversified biofilm. These periodontopathogens cause an impaired immune response leading to the loss of periodontal tissue [3]. Neither immune deficiencies nor the virulence of periodontal pathogens can explain why, despite the identification of periodontal pathogenic bacteria in the saliva, only a few teeth are severely affected by periodontitis in patients, or why one tooth presented alveolar bone and soft tissue destruction while the periodontium of its neighbour was barely affected
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