Subgingival Pockets Research Articles

The multispecies microbial cluster of Fusobacterium, Parvimonas, Bacteroides and Faecalibacterium as a precision biomarker for colorectal cancer diagnosis.

The incidence of colorectal cancer (CRC) has increased worldwide, and early diagnosis is crucial to reduce mortality rates. Therefore, new noninvasive biomarkers for CRC are required. Recent studies have revealed an imbalance in the oral and gut microbiomes of patients with CRC, as well as impaired gut vascular barrier function. In the present study, the microbiomes of saliva, crevicular fluid, feces, and non-neoplastic and tumor intestinal tissue samples of 93 CRC patients and 30 healthy individuals without digestive disorders (non-CRC) were analyzed by 16S rRNA metabarcoding procedures. The data revealed that Parvimonas, Fusobacterium, and Bacteroides fragilis were significantly over-represented in stool samples of CRC patients, whereas Faecalibacterium and Blautia were significantly over-abundant in the non-CRC group. Moreover, the tumor samples were enriched in well-known periodontal anaerobes, including Fusobacterium, Parvimonas, Peptostreptococcus, Porphyromonas, and Prevotella. Co-occurrence patterns of these oral microorganisms were observed in the subgingival pocket and in the tumor tissues of CRC patients, where they also correlated with other gut microbes, such as Hungatella. This study provides new evidence that oral pathobionts, normally located in subgingival pockets, can migrate to the colon and probably aggregate with aerobic bacteria, forming synergistic consortia. Furthermore, we suggest that the group composed of Fusobacterium, Parvimonas, Bacteroides, and Faecalibacterium could be used to design an excellent noninvasive fecal test for the early diagnosis of CRC. The combination of these four genera would significantly improve the reliability of a discriminatory test with respect to others that use a single species as a unique CRC biomarker.

Periodontal health status, Porphyromonas gingivalis and anti-cyclic citrullinated peptide antibodies among rheumatoid arthritis patients

Porphyromonas gingivalis (P. gingivalis) is the primary periodontal pathogen involved in protein citrullination, which triggers the production of anti-cyclic citrullinated peptide (anti-CCP) antibodies, exacerbating rheumatoid arthritis (RA). This study aims to evaluate the amount of P. gingivalis and its association with anti-CCP antibodies in RA patients with periodontitis. This cross-sectional study involves 100 RA patients with a mean age of 52.36 (SD 13.90) years. Smokers and patients with other uncontrolled systemic diseases were excluded. Disease Activity Score-28 (DAS-28) was used to determine RA disease severity. Periodontal parameters were examined to determine periodontal status. Subsequently, plaque samples were collected from the subgingival periodontal pocket for assessment of P. gingivalis bacterial load using the loop-mediated isothermal amplification method. Blood samples (5 ml) were obtained from all participants to analyse anti-CCP antibody levels. Data was analysed by using SPSS version 24.0. Most participants were female (85.0%) and had low RA disease severity (62%). The mean RA disease duration was 7.77 (SD 6.3) years, with a mean DAS-28 of 3.17 (SD 1.0). Forty-seven per cent of participants had periodontitis, but all periodontal parameters were not associated with RA disease activity (P = 0.38). P. gingivalis bacterial load ranged from 10 to 109 copies/μl. Fifty-five per cent of the collected samples showed positive anti-CCP antibody levels, but no significant association was observed with the P. gingivalis bacterial load (P = 0.58). Considering the study's limitations, although periodontitis is prevalent among RA patients, there is a lack of association between P. gingivalis bacterial load and anti-CCP antibody levels, which should be investigated further.

A STUDY ON BACTERIOLOGICAL IDENTIFICATION OF SUB-GINGIVAL PLAQUES IN PERIODONTITIS PATIENTS

Objective: The current study's objectives were to isolate and characterize the periodontal pathogens from subgingival plaque obtained from patients with chronic periodontitis using conventional microbiological techniques.
 Materials: In the Department of Microbiology at a Tertiary Care Teaching Hospital was where this study was carried out. Over the course of six months, from January to June 2019, samples were taken from subgingival pockets in patients with chronic periodontitis who visited the periodontology outpatient department at our institute of dental sciences. There were 21 cases in the research. For the purpose of preventing saliva contamination, tooth surfaces were dried using sterile gauze. Subgingival plaque samples were taken from the majority of diseased sites using a sterile periodontal Gracy curette, put in a test tube with fluid thioglycollate medium, and taken to the microbiology lab where they were processed right away using conventional microbiological procedures.
 Results: E. coli grew in the majority of samples (9), followed by Pseudomonas species and Staphylococci in 7 samples. Only sample number 7 out of 21 showed no growth for Candida albicans; the others all exhibited development. Samples like Sample 1, 5, 6, 8, 10, 11, 12, 13, 15, 16, 17, 18, 19, and 20 produced isolates that were multidrug resistant.
 Conclusion: Therefore, while developing a treatment plan for adult patients with periodontitis, the microbial diversity discovered in the current study should be taken into account. Variations in the quantities and species of cultivable bacteria have been found in investigations of periodontitis patients from different geographic regions, including developed and developing countries.

Comparative evaluation of efficacy of subgingivally delivered simvastatin and placebo gel in the treatment of stage ii periodontitis as an adjunct to scaling and root planing and its effect on porphyromonas gingivalis

Aim: To evaluate the clinical efficacy of subgingivally delivered SMV and Placebo gel and compare in the treatment of stage II periodontitis when used as an adjunct to SRP and their antimicrobial effect on the Porphyromonas gingivalis bacteria. Materials & Methods: In a split mouth study design, 10 systemically healthy patients with stage II periodontitis were included in this study based on the inclusion and exclusion criteria. Two sites with deepest pockets were selected. Plaque samples were collected from these pockets at baseline followed by full mouth scaling and root planning, In Group I 1,2% SMV gel and in Group II Placebo gel was placed in the subgingival pockets. Microbiological analysis for Colony Forming Units of P.g was done at baseline after 3 months, Clinical parameters (GI, PI, PD, CAL, mSBI) were evaluated at baseline (before SRP), 1 month and 3 months. Result: Both the groups showed significant reduction in GI, PI, PD, CAL, mSBI and CFU of Pg but Group I showed more significant reduction than Group II.

Periodontopathic Microbiota and Atherosclerosis: Roles of TLR-Mediated Inflammation Response.

Atherosclerosis is a chronic inflammatory disease with a high prevalence worldwide, contributing to a series of adverse cardiovascular and cerebrovascular diseases. Periodontal disease induced by pathogenic periodontal microbiota has been well established as an independent factor of atherosclerosis. Periodontal microorganisms have been detected in atherosclerotic plaques. The high-risk microbiota dwelling in the subgingival pocket can stimulate local and systematic host immune responses and inflammatory cascade reactions through various signaling pathways, resulting in the development and progression of atherosclerosis. One often-discussed pathway is the Toll-like receptor-nuclear factor-κB (TLR-NF-κB) signaling pathway that plays a central role in the transduction of inflammatory mediators and the release of proinflammatory cytokines. This narrative review is aimed at summarizing and updating the latest literature on the association between periodontopathic microbiota and atherosclerosis and providing possible therapeutic ideas for clinicians regarding atherosclerosis prevention and treatment.

Antimicrobial Impact of Different Air-Polishing Powders in a Subgingival Biofilm Model.

Subgingival air-polishing devices (SAPD) can reduce bacterial biofilms and thus support periodontal healing. The authors of this study evaluated the effectiveness of the glycine-based and trehalose-based air-polishing powders in removing pathogenic bacteria in a subgingival biofilm model. We treated 56 subgingival pockets in porcine jaws with SAPD. Subgingival air polishing was performed in three groups of 13 pockets each: I, glycine-based powder; II, trehalose-based powder; and III, water alone. Another group (IV) served as untreated controls. Prior to air polishing, inoculated titanium bars were inserted into the pockets containing periopathogenic bacteria such as Porphyromonas gingivalis and Tannerella forsythia. Remaining bacteria were evaluated using real-time PCR. The numbers of remaining bacteria depended on the treatment procedure, with the lowest number of total bacteria in group I (median: 1.96 × 106 CFU; min: 1.46 × 105; max: 9.30 × 106). Both polishing powders in groups I and II (median: 1.36 × 107 CFU; min: 5.22 × 105; max: 7.50 × 107) showed a statistically significantly lower total bacterial load in comparison to both group IV (median: 2.02 × 108 CFU; min: 5.14 × 107; max: 4.51 × 108; p < 0.05) and group III (median: 4.58 × 107 CFU; min: 2.00 × 106; max: 3.06 × 108; p < 0.05). Both subgingival air-polishing powders investigated can reduce periopathogenic bacteria and thus support antimicrobial therapy approaches in periodontal treatment regimens.

The Hunger Games: Aggregatibacter actinomycetemcomitans Exploits Human Neutrophils As an Epinephrine Source for Survival.

Aggregatibacter actinomycetemcomitans is a gram-negative facultative anaerobe and an opportunistic oral pathogen, strongly associated with periodontitis and other inflammatory diseases. Periodontitis is a chronic inflammation of the periodontium resulting from the inflammatory response of the host towards the dysbiotic microbial community present at the gingival crevice. Previously, our group identified catecholamines and iron as the signals that activate the QseBC two-component system in A. actinomycetemcomitans, necessary for the organism to acquire iron as a nutrient to survive in the anaerobic environment. However, the source of catecholamines has not been identified. It has been reported that mouse neutrophils can release catecholamines. In periodontitis, large infiltration of neutrophils is found at the subgingival pocket; hence, we wanted to test the hypothesis that A. actinomycetemcomitans exploits human neutrophils as a source for catecholamines. In the present study, we showed that human neutrophils synthesize, store, and release epinephrine, one of the three main types of catecholamines. Human neutrophil challenge with A. actinomycetemcomitans induced exocytosis of neutrophil granule subtypes: secretory vesicles, specific granules, gelatinase granules, and azurophilic granules. In addition, by selectively inhibiting granule exocytosis, we present the first evidence that epinephrine is stored in azurophilic granules. Using QseC mutants, we showed that the periplasmic domain of the QseC sensor kinase is required for the interaction between A. actinomycetemcomitans and epinephrine. Finally, epinephrine-containing supernatants collected from human neutrophils promoted A. actinomycetemcomitans growth and induced the expression of the qseBC operon under anaerobic conditions. Based on our findings, we propose that A. actinomycetemcomitans promotes azurophilic granule exocytosis by neutrophils as an epinephrine source to promote bacterial survival.

Association of subgingival Epstein-Barr virus and periodontitis.

Background: The Epstein-Barr virus (EBV) is gaining interest as a possible agent in the etiology of periodontitis. Previous studies have shown controversy on whether EBV DNA in the subgingival periodontal pockets is associated with periodontitis. The present study aimed to seek the potential relationship between EBV and periodontitis. Methods: Samples were taken from gingival crevicular fluid using sterile paper points, and data on sociodemographics, oral health, and periodontal health were recorded. This case-control study of 118 participants included 59 subjects with severe periodontitis and 59 control subjects with mild periodontitis. Quantitative real-time PCR was used to determined EBV load. Results: EBV DNA was detected in 37.3% of the case samples and 18.6% of the control samples. There was no significant difference in a load of EBV DNA between severe and mild periodontitis (p>0.05). The observed load of EBV DNA was up to 4.55x10 5 copies/mL. The detected EBV DNA was significantly associated with the plaque index and the oral hygiene index (p<0.05). Conclusions: Although no significant association was found, EBV may play a role in periodontitis. The real-time PCR methods can be used to monitor the EBV load in gingival crevicular fluid.

Association of subgingival Epstein–Barr virus and periodontitis

Background: The Epstein–Barr virus (EBV) is gaining interest as a possible agent in the etiology of periodontitis. Previous studies have shown controversy on whether EBV DNA in the subgingival periodontal pockets is associated with periodontitis. The present study aimed to seek the potential relationship between EBV and periodontitis. Methods: Samples were taken from gingival crevicular fluid using sterile paper points, and data on sociodemographics, oral health, and periodontal health were recorded. This case-control study of 118 participants included 59 subjects with severe periodontitis and 59 control subjects with mild periodontitis. Quantitative real-time PCR was used to determined EBV load. Results: EBV DNA was detected in 37.3% of the case samples and 18.6% of the control samples. There was no significant difference in a load of EBV DNA between severe and mild periodontitis (p>0.05). The observed load of EBV DNA was up to 4.55x10 5 copies/mL. The detected EBV DNA was significantly associated with the plaque index and the oral hygiene index (p<0.05). Conclusions: Although no significant association was found, EBV may play a role in periodontitis. The real-time PCR methods can be used to monitor the EBV load in gingival crevicular fluid.

Association of subgingival Epstein–Barr virus and periodontitis

Background: The Epstein–Barr virus (EBV) is gaining interest as a possible agent in the etiology of periodontitis. Previous studies have shown controversy on whether EBV DNA in the subgingival periodontal pockets is associated with periodontitis. The aim of the present study was to seek the potential relationship between EBV and periodontitis. Methods: Data on socio-demographics, oral health, and periodontal health were recorded, and samples were collected from gingival crevicular fluid, using sterile paper point. This case–control study of 118 participants included 59 subjects with severe periodontitis and 59 control subjects with mild periodontitis. The EBV load was determined by quantitative real-time PCR. Results: EBV DNA was detected in 37.3% of the case samples and in 18.6% of the control samples. There was no significant difference in the load of EBV DNA between severe and mild periodontitis (p&gt;0.05). The observed load of EBV DNA was up to 4.55x105 copies/mL. The detected EBV DNA was significantly associated with the plaque index and the oral hygiene index (all p&lt;0.05). Conclusions: A significant association was not found, but EBV might contribute to periodontitis. Gingival crevicular fluid is useful for monitoring the EBV load by the real-time PCR technique.

Oral Health Status and its Impact on Daily Performance in Adult Population with Diabetes

Background: According to World Health Organization (WHO), diabetes mellitus, is a silent epidemic which affects large number of people around the world and is directly related to the oral health status of the patients.&#x0D; Objectives: To know the level of oral health and its impact on daily performance in adult population with Diabetes.&#x0D; Methods: A cross sectional study was comprised of group of 100 diabetic patients (males=68, females=32) from the OPD of Dhaka Dental College and Shaheed Suhrawardy Medical college, Dental unit of Dhaka. Oral health status is assessed by WHO described DMFT caries index and CPITN (community periodontal index treatment need). And oral impact on daily performance is determined by a modified form of OIDP index. Clinical examinations were included for the assessment of Dental Status. Chi-square was used for statistical evaluation.&#x0D; Results: Mean DMFT of the study population of Decayed, Missing and filled tooth were 3.89±3.35, 3.04±2.66 and 3.87±2.66 However, in case of CPITN index of the study population, Supragingival or subgingival pocket more than 6mm was in 32% cases. Mean scores of overall impacts on daily performances (OIDP) was 2.18±1.85. Bivariate analysis revealed that the self-reported oral impacts from the participants were not significantly associated (p≥0.05) with those who were diagnosed with presence of periodontal pockets more than 6 mm (32%).&#x0D; Conclusions: Oral health is an essential part of general health. Despite dental caries was comparatively low in diabetics, periodontal status was compromised which affected the participant’s daily life chiefly through difficulty in eating. Routinely follow-up of dental problems of the diabetics and oral health education is much required.&#x0D; Update Dent. Coll. j: 2021; 11 (1): 7-10

Insertional Inactivation of Prevotella intermedia OxyR Results in Reduced Survival with Oxidative Stress and in the Presence of Host Cells.

One of the most abundant bacteria in the subgingival pockets of patients with bleeding following mechanical periodontal therapy is Prevotella intermedia. However, despite its abundance, the molecular mechanisms of its contribution to periodontal disease are not well known. This is mainly due to the lack of genetic tools that would allow examination of the role of predicted virulence factors in the pathogenesis of this bacterium. Here, we report on the first mutant in the P. intermedia OMA14 strain. The mutation is an allelic exchange replacement of the sequences coding for a putative OxyR regulator with ermF sequences coding for the macrolide–lincosamide resistance in anaerobic bacteria. The mutant is severely impaired in its ability to grow with eukaryotic cells, indicating that it is an important target for interventional strategies. Further analyses reveal that its ability to grow with oxidative stress species, in the form of hydrogen peroxide and oxygen, is severely affected. Transcriptome analysis reveals that the major deregulated genes code for the alkylhydroperoxide reductase system, AhpCF, mediating protection from peroxide stress. Moreover, genes coding for Dps, CydA and Ftn are downregulated in the mutant strain, as further verified using qRT-PCR analysis. In conclusion, we succeeded in generating the first P. intermedia mutant and show that the OxyR-deficient strain is unable to survive with a variety of host cells as well as with oxidative stress.

ОЦЕНКА МАРКЕРОВ РАЗВИТИЯ ЗАБОЛЕВАНИЙ ПАРОДОНТА НА ОСНОВАНИИ ИЗУЧЕНИЯ МИКРОБНОГО СОСТАВА РАЗЛИЧНЫХ БИОТОПОВ ПОЛОСТИ РТА

Summary. The composition of supragingival and subgingival dental plaque, gingival and oral fluid, dentogingival or periodontal pocket, are a valuable diagnostic medium for non-invasive diagnosis of inflammatory periodontal diseases, since they contain a wide variety of microorganisms, many of which are markers.&#x0D; Purpose — non-invasive assessment of markers of periodontal diseases based on the study of the microbial composition of various biotopes of the oral cavity by PCR.&#x0D; Мaterials and methods. Non-invasive diagnosis risk factors, in particular, the presence of periodontal pathogenic microflora, provided for the study of various biotopes of the oral cavity — plaque, oral and gingival fluids, the composition of the dental pocket by applying a high-quality PCR diagnostic method using commercial DNA-express kits (LLC NPF «Litech», Russia).&#x0D; Results. A comparative study of markers of the development of periodontal diseases using a qualitative version of the PCR test system in samples of subgingival plaque and dental pocket contents of individuals with initial stage I periodontitis showed 3.1 times greater prevalence of the representative of the yellow complex — Aggregatibacter actinomycetemcomitans, 1.4 times more often than the representative of the red complex P. gingivalis. In the studied material of supragingival plaque, gingival and oral fluid of individuals with gingivitis induced by dental biofilm, the representative of the yellow complex Aggregatibacter actinomycetemcomitans prevails 2.6 times more often than representatives of the red complex — P. gingivalis and Tannerella forsythia, 1.4 times the orange complexFusobacterium nucleatum. In samples of supragingival plaque in individuals with clinically healthy gums with loss of periodontal tissue, representatives of the microflora that form orange, red and yellow complexes most often predominate.&#x0D; Conclusion. The study of supragingival and subgingival plaque, gingival and oral fluid, and the dentogingival pocket using a PCR test system allows timely detection of markers of the development of inflammatory diseases, regardless of clinical condition of periodontal disease.

The secretion of cytokines by peripheral blood mononuclear cells of patients with periodontitis and healthy controls when exposed to H2S

ABSTRACT Background: Hydrogen sulfide(H2S) is a bacterial metabolite produced as a result of bacterial growth in subgingival pockets, suggested to partake in the pathogenesis of periodontitis. H2S has previously been shown to induce the secretion of the pro-inflammatory cytokines IL-1β and IL-18 via the NLRP3 inflammasome in monocytes. Objective: To investigate the non-NLRP3 inflammasome-dependent immunological response of human peripheral blood mononuclear cells (PBMCs) of periodontitis patients and healthy controls exposed to H2S in vitro. Methods: PBMCs of periodontitis patients(N = 31) and healthy controls(N = 32) were exposed to 1 mM sodium hydrosulfide (NaHS) at 37°C for 24 h and the secretion of cytokines was compared to resting cells. TNF-α, IFN-γ, IL-6, IL-8, IL-12p40, IL-12p70, IL-17, MCP-1, and IL-1Ra secretions were measured with Bio-Plex Pro™ Human Cytokine Assay. Results: H2S triggered the secretion of the pro-inflammatory IFN-γ, IL-6, IL-17, TNF-α, IL-12p40, and IL-12p70, while the reverse was seen for IL-1Ra. In addition, a higher basal secretion of IFN-γ, IL-6, IL-12p70, IL-17 and MCP-1 was seen from PBMCs of periodontitis patients compared to healthy controls. Conclusion: The bacterial metabolite H2S triggers the secretion of pro-inflammatory cytokines from PBMCs and may thus have a prominent role in the host-bacteria interplay in periodontitis.

Modified SHI medium supports growth of a disease-state subgingival polymicrobial community in vitro.

Developing a laboratory model of oral polymicrobial communities is essential for in vitro studies of the transition from healthy to diseased oral plaque. SHI medium is an enriched growth medium capable of supporting in vitro biofilms with similar diversity to healthy supragingival inocula; however, this medium does not maintain the diversity of gram‐negative bacteria more associated with subgingival plaque. Here, we systematically modified SHI medium components to investigate the impacts of varying nutrients and develop a medium capable of supporting a specific disease‐state subgingival community. A diseased subgingival plaque sample was inoculated in SHI medium with increasing concentrations of sucrose (0%, 0.1%, 0.5%), fetal bovine serum (FBS) (0%, 10%, 20%, 30%, 50%), and mucin (0.1, 2.5, 8.0 g/L) and grown for 48 hrs, then the 16S rRNA profiles of the resulting biofilms were examined. In total, these conditions were able to capture 89 of the 119 species and 43 of the 51 genera found in the subgingival inoculum. Interestingly, biofilms grown in high sucrose media, although dominated by acidogenic Firmicutes with a low final pH, contained several uncultured taxa from the genus Treponema, information that may aid culturing these periodontitis‐associated fastidious organisms. Biofilms grown in a modified medium (here named subSHI‐v1 medium) with 0.1% sucrose and 10% FBS had a high diversity closest to the inoculum and maintained greater proportions of many gram‐negative species of interest from the subgingival periodontal pocket (including members of the genera Prevotella and Treponema, and the Candidate Phyla Radiation phylum Saccharibacteria), and therefore best represented the disease community.

Molecular identification and diversity analysis of dental bacteria in diabetic and non-diabetic females from Saudi Arabia.

Periodontal disease is a chronic infectious disease, which is characterized by the damaged dental hard tissue by lactic acid generated by microorganisms after the fermentation of carbohydrates rich diet. The risk of periodontal disease is known to be higher in diabetic patients. We compared the diversity of five commonly occurring dental bacteria including Porphyromonas gingivalis, Tannerella forsythia, Capnocytophaga ochracea, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans in 14 type-2 diabetic patients and equal numbers of healthy controls. The subgingival samples were collected using sterile paper points. We used 16S rRNA sequence specific primers for PCR-based identification of dental bacteria. Our results showed that A. actinomycetemcomitans was completely absent in control subjects but present in 43% of diabetic patients. C. ochracea was highly prevalent in diabetic patients (100%) as compared to controls (28.5%). The frequency of other three bacterial species was also higher in diabetic patients than control subjects. These findings indicate that dental bacteria are highly prevalent in subgingival pockets of diabetic patients. Therefore, proper monitoring of diabetic patients for dental care is important to prevent bacterial growth and its sequela in risky individuals. Further case-control studies using larger sample size would help in validating the association between oral diseases and diabetes.

Subgingival pocket irrigation treatment of peri‐implantitis+ clinical and microbiological outcomes

Subgingival pocket irrigation treatment of peri‐implantitis+ clinical and microbiological outcomes

Subgingival bacterial microbiota associated with ovine periodontitis

ABSTRACT: Periodontitis is an inflammatory response in a susceptible host caused by complex microbiota, predominantly composed of Gram-negative anaerobic bacteria. Aiming to characterize the subgingival bacterial microbiota associated with ovine periodontitis, polymerase chain reaction (PCR) was performed in subgingival periodontal pocket samples of 14 sheep with severe periodontitis and in subgingival sulcus biofilm of 14 periodontally healthy sheep in search mainly of Gram-negative and Gram-positive microorganisms considered important periodontopathogens. The most prevalent bacteria in the sheep with periodontal lesions were Tannerella forsythia (78.6%), Treponema denticola (78.6%), Fusobacterium nucleatum (64.3%), and Porphyromonas gingivalis (50%), whereas in the healthy sheep, F. nucleatum (42.8%) was the most often detected bacterium. Statistically significant differences were observed for Campylobacter rectus, Enterococcus faecium, Prevotella nigrescens, T. forsythia, and T. denticola (p&lt;0.05) in the sheep with periodontitis in the comparison between groups. Aggregatibacter actinomycetemcomitans, Enterococcus faecalis, and Porphyromonas gulae were not detected in any of the samples analyzed. In conclusion, C. rectus, E. faecium, P. nigrescens, T. forsythia, and T. denticola were associated with severe lesions caused by ovine periodontitis, and F. nucleatum was the most prevalent microorganism in the subgengival sulcus biofilm of healthy sheep.

Comparative evaluation of C-reactive protein and complete blood count in chronic periodontitis patients following Phase I therapy: A serological and hematological study.

Background:Periodontitis is an example of persistent low-grade disease. The primary cause for the disease is anaerobic gram-negative bacteria thriving in a protective biofilm in subgingival periodontal pockets. The treatment of this infection is removal of these deposits by mechanical instrumentation (Phase I therapy). This can help achieve reduction of the bacterial load thus suppressing localized inflammation. Phase I therapy or mechanical debridement of the subgingival area causes a severe transient bacteremia along with some damage to the surrounding soft tissue, resulting in a systemic inflammatory response being elicited. The objective of the current study was to comparatively assess periodontal parameters, serum C-reactive protein (CRP) levels, and transitory alterations in hematological parameters; in 30-systemically healthy patients having chronic periodontitis, before and after Phase I therapy.Materials and Method:The individuals underwent an intensive session of mechanotherapy with ultrasonic scalers. Blood samples were taken before treatment and at 1, 7, and 30 days after treatment to assess the parameters.Results:There was a clear recuperation in periodontal parameters as well as marked improvement in the values of CRP and complete blood count (CBC) by 30 days after transient alterations occurring initially.Conclusion:Phase I (mechanotherapy) – the first step in treatment of periodontitis leads to transient bacteremia by systemic dispersal of bacteria harbored in dental plaque. This produces an acute-phase response resulting in variations in the levels of CRP and the CBC counts. After a month, both periodontal and hematological parameters show marked improvement, thus establishing periodontal health and decreasing the risk of inadvertent cardiovascular or thromboembolic episode.

Comparison of Oral Microbe Quantities from Tongue Samples and Subgingival Pockets.

Objectives To improve understanding of periodontitis pathology, we need more profound knowledge of relative abundances of single prokaryotic species and colonization dynamics between habitats. Thus, we quantified oral microbes from two oral habitats to gain insights into colonization variability and correlation to the clinical periodontal status. Methods We analyzed tongue scrapings and subgingival pocket samples from 237 subjects (35–54 years) with at least 10 teeth and no recent periodontal treatment from the 11-year follow-up of the Study of Health in Pomerania. Relative abundances of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Streptococcus sanguinis, total bacteria, and Archaea were correlated to clinically assessed pocket depths (PD) and clinical attachment levels (CAL). Results Increased relative abundances of P. gingivalis, A. actinomycetemcomitans, and F. nucleatum were linked to increased levels of PD and CAL (i) on the subject level (mean PD, mean CAL) and (ii) in subgingival pockets. Relative abundances of Archaea from tongue samples correlated negatively with mean PD or mean CAL. Detection and quantity of bacterial species correlated weakly to moderately between the tongue and subgingival pocket, except for Archaea. Conclusions Relative abundances of specific oral species correlated weakly to moderately between habitats. Single species, total bacteria, and Archaea were linked to clinically assessed severity of periodontitis in a habitat-dependent manner.