Assessment of Subgingival Biofilm and its Relationship with the Status of Tumors in a Population with Breast Cancer

This study aimed to compare the subgingival microbiota of subjects with and without breast cancer (BC). Patients with BC (Group 1; n= 50) and without BC (Group 2; n=50) with periodontitis (A) and without periodontitis (B). The study was conducted in two phases (P1 and P2). One biofilm sample was collected from each subject and analyzed by DNA-DNA Hybridization (Checkerboard DNA-DNA). The relative abundance of the subgingival microbiota differed between the Case and Control groups. However, some species were higher in patients in the Case than in Control subjects and differed between the groups in both phases. Composition of the subgingival microbial community according to the Socransky complex was related to periodontal disease, followed by clinical attachment of level (CAL ≥4mm), age, and tooth loss, which were found to be abundant in Cases when compared with controls. Patients with Tumor Grade II and III had a higher prevalence of tooth loss and CAL≥4mm. It was concluded that in individuals with BC, the sub-gingival microbiota exhibited atypical changes, but they developed periodontal disease.

El objetivo de este estudio fue comparar la microbiota subgingival de sujetos con y sin cáncer de mama (CM). Pacientes con CM (Grupo 1; n= 50) y sin CM (Grupo 2; n=50) con periodontitis (A) y sin periodontitis (B). El estudio se realizó en das fases (P1 y P2). Se recogió una muestra de biopelícula de cada sujeto y se analizó mediante hibridación ADN-ADN (tablero de ajedrez ADN-ADN). La abundancia relativa de la microbiota subgingival difirió entre los grupos de Caso y Control. Sin embargo, algunas especies fueron más altas en los pacientes del Caso que en los sujetos del Control y difirieron entre los grupos en ambas fases. La composición de la comunidad microbiana subgingival según el complejo de Socransky se relacionó con la enfermedad periodontal, seguida por el nivel de inserción clínica (CAL≥4mm), la edad y la pérdida de dientes, que se mostró abundante en los casos en comparación con los controles. Los pacientes con Tumor Grado II y III tuvieron mayor prevalencia de pérdida dental y CAL≥4mm. Se concluyó que en individuos con CM la microbiota subgingival presentó cambios atípicos, pero sin embargo, desarrollaron enfermedad periodontal.

High-throughput sequencing analysis of the microbiota of subgingival plaque in patients with periodontitis / 口腔疾病防治

Objective @# To detect the composition of the subgingival microbiota in generalized aggressive periodontitis (GAgP) and severe chronic periodontitis (SCP) patients tested by high-throughput sequencing (HTS) technologies, analyze its diversity and function by using bioinformatics, and observe changes in the subgingival microbiota before and after periodontal initial therapy.@* Methods@#Eleven patients with GAgP and 14 patients with SCP who visited the Department of Periodontics in Stomatological Hospital of Kunming Medical University from September 2018 to May 2019 were recruited, and subgingival plaque samples were collected at baseline and 6 weeks after initial therapy. Then, the genomic DNA was distracted and sequenced by the Illumina MiSeq high-throughput sequencing platform. QIIME (quantitative insights in microbial ecology), Mothur, SPSS and other software were used to analyze community information. LEfSe difference analysis (linear discriminant analysis effect size), network analysis, and the KEGG PATHWAY database (https://www.kegg.jp/kegg/pathway.html) were used to predict community function. @* Results @# At baseline, the dominant microbiota of GAgP and SCP patients were similar, including Bacteroidetes, Porphyromonas and Porphyromonas endodontalis. Six weeks after initial therapy, as the periodontal pocket became shallower, the variation trend of the microbiota of GAgP and SCP patients was similar. The relative abundance of gram-negative bacteria, such as Bacteroidetes, Porphyromonas and Porphyromonas endodontalis, decreased, while the relative abundance of gram-positive bacteria, such as Proteobacteria, Actinomyces and Rothia aeria, increased. Actinobacteria were significantly increased biomarkers of the subgingival microbiota in GAgP after treatment. Streptococcus is an important genus that connects the microbiota related to periodontitis and the microbiota related to periodontal health. Community function prediction result showed that initial treatment can reduce the functions of amino acid metabolism, methane metabolism, and peptidase in GAgP and SCP patients.@*Conclusion@#The subgingival microbiota of GAgP and SCP patients are similar. Streptococcus, as an early colonizer, may play an important role in promoting plaque biofilm formation and maturation in the process of subgingival flora from health to imbalance. Initial therapy can change the composition and structure of the subgingival microbiota, reduce community diversity, and reduce the functions of amino acid metabolism, methane metabolism, and peptidase in GAgP and SCP patients.

Frecuencia de Pseudomonas aeruginosa en bolsas periodontales de pacientes con Periodontitis Crónica / Frequency of Pseudomonas aeruginosa in periodontal pockets of patients with Chronic Periodontitis

La periodontitis crónica es una patología caracterizada por la destrucción de los tejidos de soporte del diente. Existe evidencia científica de la presencia en bolsas periodontales de Pseudomonas aeruginosa, bacteria que altera la microbiota subgingival. Ha sido asociada al fracaso en el tratamiento de la periodontitis y podría constituir un riesgo para la salud general de los pacientes. El objetivo de esta investigación fue determinar la frecuencia de P. aeruginosa en bolsas periodontales de pacientes con periodontitis crónica que acudieron a la cátedra de Periodoncia de la Universidad Autónoma de Asunción. El estudio fue observacional descriptivo de corte transversal, para el mismo fueron seleccionados pacientes con periodontitis crónica que cumplían con los criterios de inclusión. Las piezas dentariasseleccionadas para la toma de muestras fueron aisladas con rollos de algodón estéril, y una vez removida la placa bacteriana supragingival, se retiró la placa subgingival de las bolsas periodontales por medio de curetas de Gracey y se introdujeron en tubos de ensayo que contenían medio de Stuart, para luego llevar las muestras hasta el laboratorio de microbiología para su análisis. Del total de 14 muestras, solo una dio positivo a P. aeruginosa representando el 7,14%. El microrganismo aislado resultó resistente a los antibióticos utilizados como coadyuvantes en el tratamiento de la periodontitis crónica,al igual que en otros trabajos encontrados en la literatura internacional. La presencia de estas bacterias dificulta el control de la enfermedad periodontal y podría significar un riesgo para desarrollar infecciones oportunistas, especialmente en los pacientes inmunodeprimidos

Chronic periodontitis is a pathology characterized by the destruction of tooth supporting tissues. There is scientific evidence of the presence in periodontal pockets of Pseudomonas aeruginosa, a bacterium that alters the subgingival microbiota and that has been associated with failure to treat periodontitis and could constitute a risk to patient general health. The objective of this research was to determine the frequency of P. aeruginosa in periodontal pockets of patients with chronic periodontitis who attend the Chair of Periodontology at the Autonomous University of Asunción. Descriptive, cross-sectional observational study, in which patients with chronic periodontitis who met the inclusion criteria were selected. The pieces selected for sampling were isolated with sterile cotton rolls, and once the supragingival bacterial plaque had been removed, the subgingival plaque was removed from the periodontal pockets by means of Gracey curettes and placed in test tubes containing Stuart medium, then the samples were taken to the microbiology lab for analysis. Of the total of 14 samples, only one was positive for P. aeruginosa, representing 7.14%. The isolated microorganism was resistant to the antibiotics used as adjuvants in the treatment of chronic periodontitis, as in other studies found in the international literature. The presence of these bacteria makes it difficult to control periodontal disease and could pose a risk for developing opportunistic infections, especially in immunosuppressed patients

Subgingival microbial profile of women with breast cancer: a cross-sectional study

Background: Some prospective studies have observed associations between periodontal disease and breast cancer. Therefore, the aim of the present study was to investigate the composition of the subgingival biofilm of women diagnosed with breast cancer, who also presented with chronic periodontitis. Methods: All subjects underwent clinical and microbiological assessment. Subgingival biofilm samples were taken from at least three sites of 44 women who had breast cancer. The mean levels and proportions of 40 bacterial species were determined by checkerboard DNA-DNA hybridization. Spearman correlation was used to assess possible associations between the mean levels of bacterial species and clinical conditions. Results: The five species found at the highest levels were Prevotella nigrescens, Actinomyces gerencseriae, Neisseria mucosa, Porphyromonas gingivalis and Tannerella forsythia. The species detected in the lowest counts were Propionibacterium acnes, Streptococcus constellatus, Streptococcus intermedius, Eubacterium saburreum and Streptococcus anginosus. No significant association between levels and proportion of bacterial species and clinical parameters were found. Conclusion: In conclusion, the results of the present study found no direct association between the subgingival microbiota and breast cancer and an indirect pathway should be addressed in further studies.

Efeito do tratamento periodontal não cirúrgico em pacientes com periodontite crônica e agressiva: achados microbiológicos e imunológicos / Effect of non surgical periodontal treatment in chronic and aggressive subjects: microbiological and immunological findings

O objetivo do presente estudo foi comparar a expressão de IL-1β, IL-4, IL-8, interferon-γ, atividade de elastase e a composição do perfil microbiano subgengival antes e depois do tratamento periodontal não cirúrgico em pacientes com doença peridontal crônica generalizada (PC) e agressiva generalizada (PA). Vinte pacientes com PC e quatorze com PA foram avaliados. Dados clínicos, fluido gengival e biofilme subgengival foram analisados na visita inicial (VI) e 3 meses (3M) após o tratamento periodontal não cirúrgico. Amostras de fluido gengival (FG) foram coletadas com tiras de papel e os níveis de: IL-1β, IL-4, IL-8 e INF-γ foram medidos, utilizando um tipo de imunoensaio multiplexado (Luminex). Atividade da elastase foi avaliada por um ensaio enzimático. Amostras de placa subgengival foram analisadas através do checkerboard DNA-DNA hybridization. Na avaliação de 3 meses após terapia periodontal foi encontrado melhora significativa para todos os parâmetros clínicos em ambos os grupos. Foram encontradas reduções significativas na atividade de elastase nos sítios rasos e profundos dos pacientes do grupo PA e nos sítios profundos do grupo PC, também foi achado um aumento significativo de INF-γ nos sítios rasos do grupo PA. Os dados microbiológicos, mostraram reduções significativas para os níveis dos membros do complexo vermelho (P. gingivalis, T. forsythia, T.denticola), e para as espécies E.nodatum e P.micra no grupo PC. No grupo PA, ocorreram reduções significativas no níveis de P. gingivalis, T. forsythia, Fusobacterium nucleatum ss polymorphum e Fusobacterium periodonticum. Quando as respostas clínica e imunológica 3M após terapia foram comparadas entre os grupos, apenas diferenças sutis foram observadas. Nenhuma diferença microbiológica foi encontrada entre os grupos após a terapia. Em conclusão, os achados suportam nossa hipótese de que as periodontites cronica e agressiva respondem de forma semelhante ao tratamento periodontal nao cirúrgico.

Our aim was to compare the expression of IL1β, IL-4, IL-8, INF-γ, elastase activity and the composition of the subgingival microbiota profile before and after non-surgical periodontal treatment in patients with untreated generalized chronic (GCP) and aggressive periodontitis (GAgP). Twenty patients with GCP and 14 with GAgP were evaluated. Clinical data, GCF and plaque were analyzed at baseline and 3 months after non-surgical periodontal treatment. IL-1β, IL-4, IL-8 and INFγ were analyzed in a luminex assay. Elastase activity was assessed by an enzymatic assay. Subgingival plaque samples were analyzed using checkerboard DNA-DNA hybridization. Three months after periodontal therapy significant improvement for all clinical parameters in both groups were found. We have found significant reductions in the elastase activity in shallow and deep sites from GAgP and in deep sites from GCP group. A significant increase in INF-γ in the shallow sites from GAgP group were also found. Microbiological data showed significant reductions in the levels of members of the red complex (P. gingivalis, T. forsythia, T. denticola), and for the species E.nodatum and P.micra on GCP group. In the GAgP group, there were significant reductions in levels of P. gingivalis, T. forsythia, Fusobacterium nucleatum and Fusobacterium polymorphum ss periodonticum. When the clinical and immunological responses after therapy were compared between groups, only slight differences were found. No microbiological difference was found between groups after therapy. In conclusion, the findings support our hypothesis that the chronic and aggressive periodontitis respond equally well to non-surgical periodontal treatment.

Microorganismos inusuales en surcos y bolsas periodontales / Unusual microorganisms in gingival sulcus and periodontal pockets

Introducción: Los microorganismos de la familia Enterobacteriaceae, los bacilos Gram negativos no fermentadores y ciertas especies de Candida se han considerado como inusuales en quienes sufren enfermedad periodontal, y en ellos el tratamiento mecánico o antimicrobiano puede ser poco efectivo para resolver o controlar la progresión de la enfermedad. Objetivos: Analizar los perfiles microbiológicos en individuos sanos y en pacientes con diagnóstico de periodontitis crónica y periodontitis agresiva, determinar la frecuencia de los microorganismos inusuales y las posibles asociaciones con algunos microorganismos periodontopáticos en la base de datos del laboratorio de microbiología oral y periodontal en Cali. Materiales y métodos: Se estudiaron los informes microbiológicos de 356 pacientes en un período de 41 meses. Las variables analizadas fueron: diagnóstico periodontal, recuento total de colonias, porcentaje de aislamiento de diez microorganismos periodontopáticos y de otros inusuales como miembros de la familia Enterobacteriaceae, bacilos Gram negativos no fermentadores y levaduras. Resultados: Se analizaron 202 (56.7%) informes de pacientes con periodontitis crónica, 139 (39.1%) de periodontitis agresiva y 15 (4.2%) de individuos periodontalmente sanos. La presencia de microorganismos inusuales de tipo entérico fue 36% y la prevalencia de levaduras 7% en las personas con periodontitis. No se encontraron diferencias significantes entre los tres diagnósticos clínicos con respecto a la presencia de microorganismos entéricos y levaduras. La mayor prevalencia de organismos entéricos correspondió a los géneros Klebsiella, Enterobacter y a bacilos Gram negativos no fermentadores. Se encontraron asociaciones estadísticamente significativas entre la presencia o ausencia de microorganismos infrecuentes con la de algunos microorganismos periodontopáticos en los individuos con enfermedad periodontal.

Introduction: Microorganisms of the Enterobacteriaceae family, non-fermentative Gram negative rods and species of Candida (yeast) have been considered as unusual microorganisms in patients with periodontitis, where antimicrobial and mechanical treatment have been often ineffective to solve or control the disease progression. Objectives: To analyze the microbiological profiles in periodontally healthy individuals, and in chronic and aggressive periodontitis patients; to determine the frequency of detection of unusual microorganisms and the possible associations with some periodontopathic bacteria in an oral microbiology laboratory database in Cali. Material and methods: Microbiological reports of 356 patients were analyzed in a period of 41 months. The variables were periodontal diagnosis, total colony counts, percentage of isolation of ten periodontal bacteria, Enterobacteriaceae spp; non-fermentative Gram negative rods and yeasts were also included in the analyses. Results: Reports of 202 (56.7%) patients with chronic periodontitis, 139 (39.1%) of patients with aggressive periodontitis and 15 (4.2%) of periodontally healthy individuals were found. The presence of unusual microorganisms of the Enterobacteriaceae family was 36% and the prevalence of yeast was 7% in the periodontitis patients. Among the three clinical diagnoses no significant differences were found with respect to the presence of enteric organism and yeasts. The greatest prevalence of enteric organisms belonged to Klebsiella spp, Enterobacter and non-fermentative Gram negative rods. Significant associations were found between the presence and absence of unusual microorganisms related to Actinobacillus. actinomycetemcomitans.

Estado periodontal y microbiota subgingival en mujeres preeclampticas / Periodontal status and subgingival microbiota in women with preeclampsia

Objetivos: describir el estado periodontal y la microbiota subgingival de mujeres gestantes con diagnostico de preeclampsia en el Hospital Universitario del Valle (HUV) de Cali-Colombia. Metodología: participaron 8l mujeres con diagnóstico de preeclampsia, internadas en el HUV,se les colectaron datos médicos, odontológicos y periodontales tales como profundidad de sondeo, nivel de inserción clínico, se tomaron muestras microbiológicas subgingivales paracultivo y se realizo el diagnóstico clínico periodontal teniendo en cuenta los parámetros de la AAP consensus report-1999. Resultados: el 63% de la gestantes presento preeclampsia leve y el 27.2% preeclampsia severa. Un 91.4% (n=74) de las pacientes presentoafección en el estado de salud periodontal dentro del cual el 59.3% (n=48) presentó un diagnóstico de periodontitis crónica y solo el 8.6% de las gestantes presento un buen estadode salud periodontal. Los microorganismos periodontopáticos más frecuentes en las mujeres con preeclampsia fueron Fusobacteriumssp 80.2% (n=65), Porphyromonas gingivalis 59.3% (n=48) y Prevotella intermedian/nigrescens 51.9% (n=42).Conclusiones: Se encontró en un alto porcentaje de mujeres con preeclampsia afección en el estado periodontal predominando un diagnostico clínico de periodontitis crónica y presencia de una microbiota periodontopática y solo unbajo porcentaje de las gestantes presentaron un estado de salud periodontal.

Objective: to describe the clinical periodontal status and the subgingival microbiota composition in a group of 81 women having preeclampsia. Methods: clinical, medical and periodontal datawere determined in women with preeclampsia at the University Hospital of Valle in Cali-Colombia. Periodontal status and diagnosis were determined by means of probing depth and clinical attachment level (Diagnosis ConsensusAAP-1999). A sample of subgingival plaque was taken for microbiological analysis. Results: 63% of the cases had mild preeclampsiaand 27.2% had severe preeclampsia. The periodontal status was affected in 91.4% of patients (n=64); 59.3% (n=48) of them presented chronic periodontitis and only 8.6% presentedhealthy periodontium. Periodontopathic bacteria was found in preeclamptic women, the most prevalent microorganisms were Fusobacteriumssp 80.2% (n=65), P. gingivalis 59.3% (n=48) and Prevotella intermedia/nigrescens 51.9% (n=42).Conclusion: preeclamptic women showed a high percentage of chronic periodontitis and presented also periodontopathic microbiota. A low percentage of pregnant women presented healthy periodontium.

Estado periodontal y microbiota subgingival en mujeres preeclampticas / Periodontal status and subgingival microbiota in preeclamptic women

Objetivos: Describir el estado periodontal y la microbiota subgingival de mujeres gestantes con diagnostico de preeclampsia en el Hospital Universitario del Valle (HUV) de Cali-Colombia. Metodología: Participaron 81 mujeres con diagnóstico de preeclampsia, internadas en el Hospital Universitario del Valle, a quienes se les colectaron datos médicos y periodontales tales como profundidad al sondeo, nivel de inserción clínica, índice gingival y periodontal, con el fin de realizar el diagnóstico clínico periodontal teniendo en cuenta los parámetros de la Academia Americana de Periodoncia (AAP 1999); además se tomaron muestras microbiológicas subgingivales para cultivo e identificación de bacterias periodontopatógenas. Resultados: El 63 de la gestantes presentó preeclampsia leve y el 27.2 preeclampsia severa. Un 91.4 (n=74) de las pacientes presentó afección en el estado de salud periodontal dentro del cual el 59.3 (n=48) presentó un diagnóstico de periodontitis crónica y solo el 8.6 de las gestantes presentó un buen estado de salud periodontal. Los microorganismos periodontopáticos más frecuentes en las mujeres con preeclampsia fueron Fusobacterium ssp 80.2 (n=65), Porphyromonas gingivalis 59.3 (n = 48) y Prevotella intermedian/nigrescens 51.9 (n=42). Conclusiones: Se encontró que una alta proporción de las mujeres con preeclampsia tuvo afección en el estado periodontal con predominio de un diagnostico clínico de periodontitis crónica y presencia de una microbiota periodontopática. Solo un bajo porcentaje de las gestantes presentaron un estado de salud periodontal.

Objective: To describe periodontal status and subgingival microbiota composition among pre-eclamptic women institutionalized in the Hospital Universitario del Valle (HUV) – Cali- Colombia. Methods: Eighty one preeclamptic women were studied in the HUV after signing the inform consent and filling inclusion criteria. Selected patients were examined and their medical, dental, periodontal data recorded. Periodontal index used were pocket depth, clinical attachment loss six measurements by tooth in the whole dentition except third molars. Subgingival samples for bacterial culture were taken and Periodontal diagnosis made according to the American Academy of Periodontology (AAP) concensus report-1999. Results: Sixty three percent of women had slight pre-eclampsia and 27.2 severe preaclampsia. Ninety one percent women (n=74) had certain degree of gingival and periodontal afection. Fifty nine percent (n=48) had Chronic Periodontitis and only 8.6 preeclamptic women had oral health. More prevalent periodontal organisms among pre-eclamptic women were Fusobacterium ssp 80.2 (n=65), Porphyromonas gingivalis 59.3 (n = 48) and Prevotella intermedian/nigrescens 51.9 (n=42). Conclusions: More pre-eclamptic women had chronic periodontitis and also harbored in their subgingival microbiota important periodontophatic organisms. Treatment of periodontal disease before or during pregnancy might be important to reduce medical and systemic health complications.