Etiology Of Periodontitis Research Articles

Prospective and challenges of locally applied repurposed pharmaceuticals for periodontal tissue regeneration.

Periodontitis is a persistent inflammatory condition that causes periodontal ligament degradation, periodontal pocket development, and alveolar bone destruction, all of which lead to the breakdown of the teeth's supporting system. Periodontitis is triggered by the accumulation of various microflora (especially anaerobes) in the pockets, which release toxic substances and digestive enzymes and stimulate the immune system. Periodontitis can be efficiently treated using a variety of techniques, both regional and systemic. Effective therapy is dependent on lowering microbial biofilm, minimizing or eradicating pockets. Nowadays, using local drug delivery systems (LDDSs) as an adjuvant therapy to phase I periodontal therapy is an attractive option since it controls drug release, resulting in improved efficacy and lesser adverse reactions. Choosing the right bioactive agent and mode of delivery is the foundation of an efficient periodontal disease management approach. The objective of this paper is to shed light on the issue of successful periodontal regeneration, the drawbacks of currently implemented interventions, and describe the potential of locally delivered repurposed drugs in periodontal tissue regeneration. Because of the multiple etiology of periodontitis, patients must get customized treatment with the primary goal of infection control. Yet, it is not always successful to replace the lost tissues, and it becomes more challenging as the defect gets worse. Pharmaceutical repurposing offers a viable, economical, and safe alternative for non-invasive, and predictable periodontal regeneration. This article clears the way in front of researchers, decision-makers, and pharmaceutical companies to explore the potential, effectiveness, and efficiency of the repurposed pharmaceuticals to generate more economical, effective, and safe topical pharmaceutical preparations for periodontal tissue regeneration.

Influence of betel nut chewing on oral microbiome in Papua New Guinea

Abstract Background and objectives For thousands of years, betel nut has been used as a psychoactive agent in Asian and Oceanian populations. Betel nut chewing was associated with the alteration of human oral microbiome and with diseases such as oral cancer and periodontitis, but only in populations of Asian cultural background. We studied the influence of betel nut chewing on the oral microbiome in Papua New Guinea, where half of the population uses betel nut and the prevalence of these diseases is one of the highest in the world. Methodology We characterised the oral microbiomes of 100 Papua New Guineans. We defined two cohorts of betel chewers (n=50) and non-chewers (n=50) based on a genetic approach to identify the presence of betel nut in saliva. We statistically compared the alpha and beta microbial diversities between the two cohorts. We performed linear discriminant analyses to identify bacterial species more prevalent in each cohort. Results We found that oral microbial diversity is significantly different between betel chewers and non-chewers. The dysbiosis observed in betel chewers, led to an increase of pathogenic bacterial species including Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia, known to be in the aetiology of periodontal diseases. Conclusions and implications Our study strongly supports the alteration of human oral microbiome by betel nut use, potentially leading to periodontal diseases. It also shows the need to consider local specificities (e.g. different habits, betel nut types, and oral microbial diversities) to better characterise the impact of betel nut chewing on health.

Modern views on the etiology and role of microbial persistence in the development of inflammatory processes in the periodontal complex (review)

Alveolar tissue diseases cause the appearance of dentition defects, thereby reducing the patients' work capacity and quality of life. The purpose of this research was to investigate, modern views on the etiology of periodontitis and the role of microbial persistence in the development of inflammatory processes of periodontal complex basing on a review of literary sources. Literature review was conducted using PubMed, Web of Science, Scopus, Google Scholar from 2018 to March 2024. There were no restrictions on the date of publication or the language of scientific sources. Searches were conducted according to MeSH (Medical Subject Headings) with using the following search terms: "periodontitis", "oral mucosa", "gums", "dental plaque", "periodontium", "traumatic occlusion", "microorganisms". In total, during the initial analysis 82 literary sources were selected and processed, after further systematization of the selected information using general scientific methods, 70 of them remained. Used methods: bibliographic and analytical. Generalized perio­dontitis is a chronic inflammatory-dystrophic process that occurs as a result of various factors. In the pathogenesis of this disease, the key role is played by the inflammatory process, which is a complex interaction of microcirculatory, he­matological and connective tissue reactions to the lesion. Local (exogenic) and general (endogenic) causative factors are distinguished. The main factors that cause pathological changes in periodontium are bacterial biofilm, traumatic occlusion and various anatomical anomalies. Dental plaque occupies a special and main place among the causes of periodontitis. At present, leading pathogenetic links in the development of the inflammation in the periodontium, in par­ticular, the disruption of free radical oxidation, the processes of peroxide oxidation of lipids and proteins, the disorder of the functional state of the antioxidant system, the formation of oxidative stress, as well as the humoral link of adaptive immune protection and cytokinesis, have not been sufficiently studied. There is no doubt about the role of the microbial factor in the etiology of periodontal diseases, but the penetration of microbes into the periodontium does not always lead to the development of the disease, because the organism has a number of protective mechanisms that counteract the development of inflammation.

THE IMMUNOMODULATORY ROLE OF CYTOKINES IN THE PATHOGENESIS OF PERIODONTAL DISEASE

Background:Inflammatory periodontal diseases are one of the most acute problems of modern dentistry, which is associated with their widespread prevalence in the world. In the structure of periodontal diseases, periodontitis a leading place in the age group of 40-50 years. Many factors play a role in the etiology of periodontitis, the most important of which are the local microbiota and the host immune response. Cytokines play an extremely important role. Cytokines are key modulators of both homeostasis and inflammatory processes, acting in the first wave of responses against pathogens, stimuli at barrier sites and linking tissue cells to lymphocytes and additional cell populations. Objective:The aim of the study was to analyze modern literature on the role of cytokines in the etiology and pathogenesis of inflammatory periodontal diseases. Materials and methods:Data Extraction: A comprehensive electronic literature search was performed in the following databases:PubMed, Scopus,Web of Scienc, Google Scholar, EBSCO host from 2000 to 2024 terms: periodontitis, infection, inflammation, immunity, cytokines, interleukin. 124 articles were found and 50 full-text articles of high methodological quality were selected according to the review method used, the PRISMA. Inclusion criteria:included clinical trials, considered randomized controlled trials, cross-sectional studies, casecontrol studies, and cohort studies in human subjects that evaluated the current literature on the periodontitis, infection, inflammation, immunity, cytokines, interleukin written in English articles.There was no limitation on minimal quality, minimal sample size, or the number of patients. Exclusion criteria were:original primary studies, due to language limitations , abstracts, letters to the editor, book chapters, case reports, conference abstracts, duplicate publications, and in vitro and in vivo animal experimental studies. Result:Many factors of general and local origin are involved in the development and progression of inflammatory periodontal diseases. Microorganisms and their products cause activation of the host immune system, which results in the release of cytokines and other proinflammatory biomarkers that cause tissue damage. The inflammatory process in periodontal tissues progresses through various stages, beginning with the infiltration of immune cells into the gingival tissue. Immune cells secrete proinflammatory cytokines such as interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α),which further promote inflammation and tissue destruction. The interaction between bacterial biofilm and the immune response, which is mainly controlled by cytokines, determines the course of periodontal disease. Conclusion:The etiology and pathogenesis of periodontal disease is quite complex, diverse and not yet fully disclosed. Cytokines are control and modulate the immune response in periodontitis

A preliminary study on calcifying nanoparticles in dental plaque: Isolation, characterization, and potential mineralization mechanism.

Calcifying nanoparticles (CNPs), referred to as nanobacteria (NB), are recognized to be associated with ectopic calcification. This study aims to isolate and culture CNPs from the dental plaque of patients with periodontal disease and investigate their possible role in unravelling the aetiology of periodontal disease. Supragingival and subgingival plaques were sampled from 30 periodontitis patients for CNPs isolation and culture. Alkaline phosphatase (ALP) content changes were tracked over time. Positive samples underwent thorough morphological identification via hematoxylin and eosin (HE) staining, Alizarin red S (ARS), and transmission electron microscopy (TEM). The chemical composition of CNPs analysis involved calcium (Ca) and phosphorus (P) content determination, Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD). The subgingival plaque dental group exhibited a higher CNPs isolation rate at 36.67% (11/30) compared to the supragingival dental plaque group at 66.67% (20/30). ALP activity varied among the positive, negative and control groups. Morphological observation characterized the CNPs as round, oval, and ellipsoid particles with Ca deposits. Chemical analysis revealed the Ca/P ratio was 0.6753. Hydroxyl, methyl, carbonate, phosphate, hydrogen phosphate, and dihydrogen phosphate were detected by FTIR; the main chemical components detected by XRD were hydroxyapatite and tricalcium phosphate. CNPs were found in periodontitis-related dental plaque and exhibited the potential to develop calcified structures resembling dental calculus. However, the potential involvement of ALP in CNPs formation requires deeper exploration, as does the precise nature of its role and the interrelation with periodontitis demand a further comprehensive investigation.

Microbial diagnostics in periodontal diseases.

Microbial analytical methods have been instrumental in elucidating the complex microbial etiology of periodontal diseases, by shaping our understanding of subgingival community dynamics. Certain pathobionts can orchestrate the establishment of dysbiotic communities that can subvert the host immune system, triggering inflammation and tissue destruction. Yet, diagnosis and management of periodontal conditions still rely on clinical and radiographic examinations, overlooking the well-established microbial etiology. This review summarizes the chronological emergence of periodontal etiological models and the co-evolution with technological advances in microbial detection. We additionally review the microbial analytical approaches currently accessible to clinicians, highlighting their value in broadening the periodontal assessment. The epidemiological importance of obtaining culture-based antimicrobial susceptibility profiles of periodontal taxa for antibiotic resistance surveillance is also underscored, together with clinically relevant analytical approaches to guide antibiotherapy choices, when necessary. Furthermore, the importance of 16S-based community and shotgun metagenomic profiling is discussed in outlining dysbiotic microbial signatures. Because dysbiosis precedes periodontal damage, biomarker identification offers early diagnostic possibilities to forestall disease relapses during maintenance. Altogether, this review highlights the underutilized potential of clinical microbiology in periodontology, spotlighting the clinical areas most conductive to its diagnostic implementation for enhancing prevention, treatment predictability, and addressing global antibiotic resistance.

Imbalanced EphB4/EphrinB2 Signaling Modulates Bone Resorption in Periodontitis Induced by Porphyromonas gingivalis.

Periodontitis, a chronic infectious disease in periodontal tissues, is characterized by an imbalance of alveolar bone resorption and remodeling, which eventually results in tooth loosening and even tooth loss. The etiology of periodontitis is polymicrobial synergy and dysbiosis, in which Porphyromonas gingivalis (P. gingivalis) is one of the primary pathogens responsible for periodontitis progression. The interplay of EphrinB2/EphB4 is crucial for osteoblast-osteoclast communication during bone remodeling and healing. This study investigates the mechanism of EphB4/EphrinB2 transduction modulating osteogenesis inhibition and bone resorption in periodontitis induced by P. gingivalis. An in vivo model of chronic periodontitis provoked by P. gingivalis was constructed, the inflammation and bone resorption were evaluated. The expression of EphB4 and EphrinB2 proteins in periodontal tissues was detected, which was also evaluated, respectively, in osteoblasts and osteoclasts infected with P. gingivalis in vitro. Then, a simulated coculture model of osteoblasts and osteoclasts was established to activate the forward and reverse pathways of EphB4/EphrinB2 with P. gingivalis infection. This study showed that P. gingivalis infection promoted alveolar bone resorption in rats and enhanced EphB4 and EphrinB2 expression in periodontal tissues. EphB4 and molecules associated with osteogenesis in osteoblasts infected with P. gingivalis were inhibited, while EphrinB2 and osteoclast differentiation-related markers in osteoclasts were activated. In conclusion, this study suggested that EphB4/EphrinB2 proteins were involved in alveolar bone remodeling in the process of periodontitis induced by P. gingivalis infection. Moreover, attenuated EphB4/EphrinB2 with P. gingivalis infection weakened osteoblast activity and enhanced osteoclast activity.

The Effect of Body Mass Index on the KYN/TRP Pathway in the Pathogenesis of Periodontitis

ABSTRACT
 Purpose: The tryptophan–kynurenine (TRP-KYN) pathway is associated with inflammation and kynurenine pathway (KP) dysregulation is present in overweight and obesity. Meanwhile, obesity and periodontitis are two of the most frequent noncommunicable illnesses, and epidemiological studies show that obesity has a role in the initiation and progression of periodontitis. However, the association between elevated body mass index and KP on periodontal disease etiology is unknown. As a result, our study is aimed to investigate the possible relationship within TRP/KYN ratio and BMI relationship in periodontitis.
 Materials & Method: The study comprised 20 periodontitis patients (P, Generalized Stage III Grade B, n=20) and 20 healthy persons (C, n=20). Clinical parameters (Bleeding index on probing (BOP), clinical attachment loss (CAL) and pocket depth (PD)), and BMI were recorded at the beginning of the study. Salivary and serum KYN/TRP ratios were analyzed by using mass spectrometry–liquid chromatography (LC-MS/MS).
 Results: Clinical periodontal parameters were statistically significantly higher in P group than in C group (p

Periodontal disease etiology and role of oxidative stress

The term "periodontal disease" is used to describe an array of inflammatory conditions that can affect the periodontium. In response to the challenge given by the bacteria, the gingival and periodontal tissues undergo a complicated chain of events involving communication It is between the membranes of a vital nature located under the gums and the person's immune inflammatory reaction. When there is an imbalance between the oxidants and the antioxidants in the body, this is known as oxidative stress. Antioxidants are compounds that may either seek out and destroy oxidants or prevent them from forming in the first place. Some of the oxidants produced by-products of normal cellular metabolism include reactive oxygen species and reactive nitrogen species. These byproducts are known as reactive oxygen and reactive nitrogen species, respectively. The presence of reactive oxygen species (ROS) has been shown to be associated with periodontal disease in research.

Comparison of red blood cell parameters in patients with and without periodontitis – A hospital based observational study

Dental plaque bio film aggregate around dentition is the primary etiology of periodontitis. The host inflammation mounted in response to bacterial biofilm determines the extent and severity of periodontitis. The low grade inflammation results increase in pro inflammatory cytokine levels, and this links periodontitis with other systemic diseases. Epidemiologic studies have revealed a possible association of periodontitis with some systemic diseases. There are conflicting results regarding the association of periodontitis and anemia. The aim of the study was to compare the red blood cell parameters in subjects with and without periodontitis in our population.A single calibrated examiner was entrusted to do the periodontal examination, and 48 subjects with periodontitis (Group I) and 50 age matched subjects without periodontitis (Group II) with a mean age of 33.45 yrs. +/- 7.86 were recruited for the study. Gingival index and full mouth periodontal charting were done and 2ml blood samples were collected for estimation of blood parameters.Group I showed a statistically insignificant difference in hemoglobin levels compared to group II (P value-0.065) where as MCH and MCHC showed a statistically significant difference between the groups (P value-0.012, 0.002 respectively).The inflammatory burden increases with the severity of Periodontitis and this may lead to the development of anemia.

Site-specific autonomic vasomotor responses and their interactions in rat gingiva

Blood flow in the gingiva, comprising the interdental papilla as well as attached and marginal gingiva, is important for maintaining of gingival function and is modulated by risk factors such as stress that may lead to periodontal disease. Marked blood flow changes mediated by the autonomic (parasympathetic and sympathetic) nervous system may be essential for gingival hemodynamics. However, differences in autonomic vasomotor responses and their functional significance in different parts of the gingiva are unclear. We examined the differences in autonomic vasomotor responses and their interactions in the gingiva of anesthetized rats. Parasympathetic vasodilation evoked by the trigeminal (lingual nerve)-mediated reflex elicited frequency-dependent blood flow increases in gingivae, with the increases being greatest in the interdental papilla. Parasympathetic blood flow increases were significantly reduced by intravenous administration of the atropine and VIP antagonist. The blood flow increase evoked by acetylcholine administration was higher in the interdental papilla than in the attached gingiva, whereas that evoked by VIP agonist administration was greater in the attached gingiva than in the interdental papilla. Activation of the cervical sympathetic nerves decreased gingival blood flow and inhibited parasympathetically induced blood flow increases. Our results suggest that trigeminal-parasympathetic reflex vasodilation 1) is more involved in the regulation of blood flow in the interdental papilla than in the other parts of the gingiva, 2) is mediated by cholinergic (interdental papilla) and VIPergic systems (attached gingiva), and 3) is inhibited by excess sympathetic activity. These results suggest a role in the etiology of periodontal diseases during mental stress.

Antimicrobial activity of chitosan nanoparticles loaded with 0.7% tetracycline against porphyromonas gingivalis

Objectives: Nanoparticle technology has also come to the fore as a viable drug delivery strategy, providing opportunities for controlled release, protecting the active ingredient from enzymatic or environmental degradation, and local retention. Porphyromonas gingivalis is a Gram-negative obligate anaerobe rod involved in the etiology of periodontal disease. Tetracycline has been widely used as an adjuvant in periodontal therapy due to its antibacterial efficacy of these drugs. 
 Material and Methods: Samples of this study were the pure culture of P. gingivalis (ATCC 33 277) in Mueller Hinton Agar (MHA). The ionic gelation method made a Chitosan nanoparticle loaded with 0.7% tetracycline. Chitosan nanoparticles loaded with 0.7% tetracycline were directly transferred to the microbiology laboratory to maintain the stability of the material. Mueller Hinton Agar media inoculated with bacteria had holes to input chitosan nanoparticles loaded with 0.7% tetracycline. After repeating these operations four times, the incubator was incubated at 37 ° C for 48 hours. Calipers were used to observe and measure the diameter of the bright zone (clear zone) formed around the hole.
 Results: The result shows the potent antimicrobial effectiveness of chitosan nanoparticles loaded with 0,7% tetracycline with an inhibitory zone of 32.8 mm in vitro. 
 Conclusion: This research has shown a potent antimicrobial activity of chitosan nanoparticles loaded with 0,7% tetracycline against P. gingivalis in vitro.

Evaluation of the effects of Curcumin gel against Periodontopathic Bacteria (Porphyromonas gingivalis) using real-time time-polymerase chain reaction technology

Periodontal disease is typically treated with mechanical debridement of the tooth surface. It may, however, be insufficient to eradicate pathogenic microorganisms on its own. Because of the microbial etiology of periodontitis, systemic or local antibiotic therapy is used as an adjunct treatment. The present study aimed to determine the effects of curcumin gel on Porphyromonas gingivalis. Eleven patients with stage II and III periodontitis were registered in the study. A double-blinded split-mouth design followed. Periodontal pockets were distributed into 2 groups; the test group received scaling and root planing along with curcumin gel, while the control group received scaling and root planing along with a placebo gel. Plaque index, probing pocket depth and relative attachment level were recorded with the collection of subgingival plaque samples at different time intervals for bacterial analysis using real-time time-polymerase chain reaction. Results showed a significant reduction in the bacterial outcomes in the test group. There was a significant improvement in the Plaque index, probing pocket depth and relative attachment level in the test group compared to the control group. On intra-group comparison, both groups showed a significant reduction of Plaque index and probing pocket depth with a more significant reduction in the test group, and only the test group showed a significant reduction of relative attachment level. A strong positive correlation of P.gingivalis with probing pocket depth and relative attachment level in the test group was estimated. Curcumin gel has an antibacterial effect against Porphyromonas gingivalis and showed a potent improvement in the outcomes of the periodontal parameters. Keywords: Curcumin gel, periodontal pocket, Porphyromonas gingivalis

Evidence linking the association of periodontal viruses and pentraxins in periodontitis patients with coronary artery disease.

Although there is ample evidence in the literature supporting a significant positive association between key periodontal pathogens and established inflammatory markers of periodontitis and coronary artery disease (CAD), their exact role remain unclear. Especially, the role of viruses in the etiology and specific biomarkers have not been validated. Thus, the current study aims to evaluate the role of periodontal viruses such as Epstein-Barr virus (EBV), cytomegalovirus (CMV), and herpes simplex virus (HSV), as well as the inflammatory marker pentraxin-3 (PTX3), and to analyze their association with CAD. The study included 240 patients divided into four groups of 60 patients each: nonperiodontitis + noncardiac (NP+NC) group, periodontitis + noncardiac patients (P+NC) group, nonperiodontitis + cardiac patients (NP+C) group, and periodontitis + cardiac (P+C) group. The cardiac surgery group (C-S) was a subgroup of NP+C and P+C. It consisted of 60 patients from the abovementioned two cardiac groups in whom coronary artery bypass graft (CABG) was indicated. Demographic variables, cardiac parameters, and periodontal parameters were recorded. The viruses (EBV, CMV, and HSV) and the inflammatory marker PTX3 were evaluated in the subgingival plaque samples of all the four groups and atheromatous plaque samples of the C-S using reverse transcriptase-polymerase chain reaction (RT-PCR) and quantitative polymerase chain reaction (qPCR), respectively, and were compared between the groups. The results were obtained and statistically analyzed. The demographic variables did not differ significantly between the groups, except for age. Systolic blood pressure, diastolic blood pressure, low-density lipoprotein, and random blood sugar were significantly higher in NP+C and P+C, whereas high-density lipoprotein was significantly lower (p≤0.05) in the same. Plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were significantly higher (p ≤ 0.05) in P+NC and P+C. PTX were significantly elevated in P+C among the four groups. On evaluating the subgingival plaque samples, EBV and CMV were significantly higher in the two periodontitis groups P+NC and P+C (p=0.000). HSV was significantly higher in the two cardiac groups (NP+C and P+C) (p ≤ 0.05). Cardiac EBV and CMV were significantly elevated in the P+C group with a p value of 0.004 and 0.033, respectively. Cardiac HSV was found in the NP+C group with statistical insignificance (p=0.410) between the groups. On correlation, oral PTX were significantly associated with bleeding index (BI), PPD, and CAL (p=0.000). Similarly, cardiac PTX showed significant association with PI, BI, PPD, and CAL (p=0.000). Oral and cardiac PTX also showed significant correlation with each other. Multiple logistic regression analysis revealed a significant association between CAL and oral EBV (p ≤ 0.05). Similarly, cardiac EBV showed a significant association with CAL and oral EBV (p ≤ 0.05). Multiple logistic regression analysis also revealed that both cardiac and oral PTX showed a significant association only with oral EBV, CMV, and HSV. The results of the current study suggest that the clinical severity of periodontitis (CAL), etiology of periodontitis (EBV and CMV), and inflammatory marker of periodontitis (PTX3) were found to be significantly elevated in CAD. These findings suggests that periodontal diseases may be a risk factor that could influence the progression of CAD.

Awareness of physicians and dentists in Serbia about the association between periodontitis and systemic diseases: a cross-sectional study

BackgroundStrong evidence supports the association between periodontitis and certain systemic diseases. The aim of the present study was to evaluate the knowledge of a group of physicians and dentists in Serbia regarding this topic and assess their professional actions to prevent and control both periodontal and systemic diseases.MethodsAn anonymous self-administered structured questionnaire was sent to the available e-mail addresses of randomly selected healthcare providers working in Serbia. According to the inclusion criteria, general practitioners, specialists, general dentists, and specialists working in government hospitals and private practices in various cities in Serbia were recruited in the study. The questionnaire consisted of 17 questions divided into three parts. The first part recorded the sociodemographic characteristics of participants, the second part included questions about the clinical manifestation and etiology of periodontitis, as well as knowledge of the association between periodontitis and systemic diseases, and the third part included questions about professional procedures for the prevention and control of periodontitis and systemic diseases.ResultsA total of 1301 health participants, 739 (57.8%) physicians and 562 (43.2%) dentists, were included in this cross-sectional study. Most respondents (94.7%) were aware of the association between periodontitis and general health. The highest percentage of respondents associated diabetes mellitus and periodontitis. Factors significantly associated with higher knowledge were female sex (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.37–2.52; p < 0.001) and dental profession (OR, 5.86; 95% CI], 4.03–8.53; p < 0.001). Participants who had higher knowledge score were more likely to ask their patients about gum/systematic health (p < 0.001) and refer them to dentists/physicians (p < 0.001).ConclusionsIt was concluded that compared to the group of dentists, the group of physicians had less knowledge of the relationship between periodontitis and systemic diseases. The female gender was significantly associated with better knowledge. A better understanding of this topic is associated with better clinical practice.

Newly identified pathogens in periodontitis: evidence from an association and an elimination study

ABSTRACT We assessed the level of evidence for the presence of new periodontal pathogens by (i) comparing the occurrence of non-classical periodontal taxa between healthy vs. periodontitis patients (Association study); (ii) assessing the modifications in the prevalence and levels of these species after treatments (Elimination study). In the Association study, we compared the prevalence and levels of 39 novel bacterial species between periodontally healthy and periodontitis patients. In the Elimination study, we analyzed samples from periodontitis patients assigned to receive scaling and root planing alone or with metronidazole+ amoxicillin TID/ 14 days. Levels of 79 bacterial species (39 novel and 40 classic) were assessed at baseline, 3 and 12 months post-therapy. All samples were analyzed using Checkerboard DNA-DNA hybridization. Out of the 39 novel species evaluated, eight were categorized as having strong and four as having moderate association with periodontitis. Our findings suggest strong evidence supporting Lancefieldella rimae, Cronobacter sakazakii, Pluralibacter gergoviae, Enterococcus faecalis, Eubacterium limosum, Filifactor alocis, Haemophilus influenzae, and Staphylococcus warneri, and moderate evidence supporting Escherichia coli, Fusobacterium necrophorum, Spiroplasma ixodetis, and Staphylococcus aureus as periodontal pathogens. These findings contribute to a better understanding of the etiology of periodontitis and may guide future diagnostic and interventional studies.

Increasing fibroblasts and gingival collagen density in periodontitis rats by using cassava leaf extract

ObjectivesPorphyromonas gingivalis, as the main etiology of periodontitis, causes inflammation in the periodontal tissue, which triggers the immune response, fibroblast decline, and collagen destruction, generating attachment loss. Fibroblasts and collagen perform a fundamental role in the repair process of periodontal tissue. This study examined the potential of cassava leaf extract in increasing the quantity of fibroblasts and collagen density in the gingiva of rats with periodontitis. MethodsA posttest-only control group was used in this study. The experiment involved 24 male Wistar rats divided into four different groups: control group, group induced by P. gingivalis and given aquadest, group induced by P. gingivalis and given metronidazole, and group induced by P. gingivalis and given cassava leaf extract. Gingival tissue was taken after euthanasia, after which histological preparations were made, and fibroblasts and collagen were observed. ResultsOne-way analysis of variance revealed that the collagen density and fibroblasts quantity showed a notable difference between each group (p < 0.05), and interestingly, there was no significant difference between metronidazole and cassava leaf extract in the least significant difference test results (p > 0.05). ConclusionCassava leaf extract has the potential to increase fibroblast quantity and collagen density in the gingiva of periodontitis rat models.

Periodontal Diseases Awareness and Knowledge Among Secondary School Teachers

Background and objectives. To determine level of knowledge related to etiology, risk factors, most common signs of periodontal diseases, knowledge related to oral hygiene practices, and relation between knowledge and oral hygiene practices among participants. Methods. 244 questionnaire answered by secondary school teachers consisted of a demographic data, and questions concerned knowledge regarding the causes of periodontal disease, its risk factors, and the most common signs of periodontal disease as well as the knowledge of periodontal diseases outcome and oral hygiene practice‑related questions. Results. Above half (54.5%) of respondents exhibited good knowledge on periodontal diseases etiology, predisposing factors and most common signs of periodontal diseases, (40.2%) of participants have positive awareness toward periodontal disease outcome, and (82.80%) of respondents have adequate behavior toward oral hygiene maintenance. Conclusions. Despite the participants have good knowledge on etiology of periodontal diseases and adequate behavior toward oral hygiene maintenance, they have deficient knowledge on hereditary, mouth breathing, stress, and obesity as predisposing factors of periodontal diseases and they have misbelief that removing the calculus accumulated on the teeth surfaces weaken the teeth.

Microbial β-glucuronidases drive human periodontal disease etiology.

Periodontitis is a chronic inflammatory disease associated with persistent oral microbial dysbiosis. The human β-glucuronidase (GUS) degrades constituents of the periodontium and is used as a biomarker for periodontitis severity. However, the human microbiome also encodes GUS enzymes, and the role of these factors in periodontal disease is poorly understood. Here, we define the 53 unique GUSs in the human oral microbiome and examine diverse GUS orthologs from periodontitis-associated pathogens. Oral bacterial GUS enzymes are more efficient polysaccharide degraders and processers of biomarker substrates than the human enzyme, particularly at pHs associated with disease progression. Using a microbial GUS-selective inhibitor, we show that GUS activity is reduced in clinical samples obtained from individuals with untreated periodontitis and that the degree of inhibition correlates with disease severity. Together, these results establish oral GUS activity as a biomarker that captures both host and microbial contributions to periodontitis, facilitating more efficient clinical monitoring and treatment paradigms for this common inflammatory disease.

Molecular Screening for High-Risk Human Papillomaviruses in Patients with Periodontitis.

Members of the Papillomaviridae family account for 27.9-30% of all infectious agents associated with human cancer. The aim of our study was to investigate the presence of high-risk HPV (human papilloma virus) genotypes in patients with periodontitis and a pronounced clinical picture. To achieve this goal, after proving the bacterial etiology of periodontitis, the samples positive for bacteria were examined for the presence of HPV. The genotype of HPV is also determined in samples with the presence of the virus proven by PCR (polymerase chain reaction). All positive tests for bacteria associated with the development of periodontitis indicated the presence of HPV. There was a statistically significant difference in HPV positive results between the periodontitis positive target group and the control group. The higher presence of high-risk HPV genotypes in the target group, which was also positive for the presence of periodontitis-causing bacteria, has been proven. A statistically significant relationship was established between the presence of periodontitis-causing bacteria and high-risk strains of HPV. The most common HPV genotype that tests positive for bacteria associated with the development of periodontitis is HPV58.