Oral microbiota analyses of paediatric Saudi population reveals signatures of dental caries.

BACKGROUND: Oral microbiome sequencing has revealed key links between microbiome dysfunction and dental caries. However, these efforts have largely focused on Western populations, with few studies on the Middle Eastern communities. The current study aimed to identify the composition and abundance of the oral microbiota in saliva samples of children with different caries levels using machine learning approaches. METHODS: Oral microbiota composition and abundance were identified in 250 Saudi participants with high dental caries and 150 with low dental caries using 16 S rRNA sequencing on a NextSeq 2000 SP flow cell (Illumina, CA) using 250 bp paired-end reads, and attempted to build a classifier using random forest models to assist in the early detection of caries. RESULTS: The ADONIS test results indicate that there was no significant association between sex and Bray-Curtis dissimilarity (p ~ 0.93), but there was a significant association with dental caries status (p ~ 0.001). Using an alpha level of 0.05, five differentially abundant operational taxonomic units (OTUs) were identified between males and females as the main effect along with four differentially abundant OTUs between high and low dental caries. The mean metrics for the optimal hyperparameter combination using the model with only differentially abundant OTUs were: Accuracy (0.701); Matthew's correlation coefficient (0.0509); AUC (0.517) and F1 score (0.821) while the mean metrics for random forest model using all OTUs were:0.675; 0.054; 0.611 and 0.796 respectively. CONCLUSION: The assessment of oral microbiota samples in a representative Saudi Arabian population for high and low metrics of dental caries yields signatures of abundances and diversity.

The effect of an antibacterial mixture and non-instrumentation endodontic treatment in primary teeth: A systematic review and meta-analyses.

Studies assessing the clinical and radiographic success of LSTR in terms of the presence of pain, mobility, swelling, fistula/sinus tract, interradicular radiolucency, and root resorption have not been performed. We therefore performed a systematic review with the aim of evaluating the effectiveness of lesion sterilization and tissue repair (LSTR), using three antibacterial mixtures (3Mix), in treating primary teeth. Well-defined search strategies developed for four electronic databases, Web of Science, OVID, PubMed, and Scopus, were used in this study. Two independent reviewers selected relevant articles from 3,232 studies by screening titles and abstracts. Based on the inclusion criteria, 25 articles were selected. Eight analyses of clinical and radiographic results were conducted based on 6, 12, 18, and 24-month follow-up intervals. Data extraction and quality appraisal were performed by three independent reviewers. The composition of antibiotic mixtures used for LSTR varied substantially, with inconsistent radiographic and clinical success rates across the included studies. A quantitative grouping of the studies showed no significant differences between 3Mix and the control medicaments regarding radiographical and clinical success (p-value > 0.05). The available evidence on different LSTR using 3Mix is scarce, and the study findings were inconsistent. Therefore, additional clinical trials on 3Mix with different compositions are needed.

Impact of international collaboration on dentistry related papers published in Kingdom of Saudi Arabia.

Objective: This bibliographic analysis was designed to review all dental publications in the Kingdom of Saudi Arabia (KSA) and evaluate the effect of international collaboration on the impact of published articles. Methods: The Web of Science (WOS) database was used to extract all related published articles in the KSA from 1982 to 2021. The keywords were connected using Boolean Operators to download related articles. Downloaded articles were screened according to the following inclusion criteria: collaboration journal category, journal discipline, number of citations, number of authors, and impact factor. After applying the inclusion criteria and excluding single-author articles, 5,689 documents were included in the final analysis. The chi-square test and two-independent samples t-test were used to determine the statistical significance between the variables. Results: A significantly higher proportion of articles with international collaboration (51.4%) were published in dental journals than those published nationally (43.3%) or within the institutional level (41.8%) (P < 0.0001). In addition, the average number of citations (9.28 ± 23.8) ranged from 0 to 749, received by an article and the impact factor of the journal in which the article was published, significantly higher in the case of internationally collaborative work compared with national or within institutional collaboration (P < 0.0001). Conclusion: International collaboration positively affected the impact factor, number of citations, and quartile rank of published articles. Moreover, the number of co-authors in different countries contributes to the international collaboration effect.

Oral microbiota analyses of Saudi sickle cell anemics with dental caries.

OBJECTIVES: The objectives of this study were to identify the composition of oral microbiota in a cohort of patients with sickle cell anemia (SCA) and a high mean number of decayed, missing, and filled permanent teeth (DMFT) and compare it to a cohort of patients with SCA and a low number of DMFT and elucidate the effect of fetal haemoglobin levels on the oral microbiota composition. METHODS: Patients who had been diagnosed with SCA, who were homozygous for sickling ß-globin mutation (ßS/ßS), who had Arab-Indian haplotype, and who ranged in age from 5 to 12 years were included in this study. Oral saliva from each participant (n = 100) was collected in GeneFiX™ Saliva DNA Microbiome Collection tube and DNA was extracted using GeneFiX™ DNA Isolation Kits. The composition of oral 16S rRNA from patients with SCA and high dental caries (n = 27, DMFT ≥5) and low dental caries (n = 73, DMFT ≤4) was analysed. Sequencing was performed on an Ion Personal Genome Machine using, Ion PGM Hi-Q view Sequencing 400-bp kit. RESULTS: We observed an overall increase in abundance of Proteobacteria, Chloroflexi, and Bacteroidetes in the high DMFT index group compared to those with a low DMFT index. In addition, there was an overall increased abundance of microbiota from Proteobacteria, Fusobacteria, Firmicutes, and Bacteroidetes in the patients with SCA with low fetal haemoglobin compared to those with high fetal haemoglobin (P < .05). Enterobacteriaceae species were the most significant abundant species of bacteria found in both the high DMFT index group and low fetal haemoglobin cohort (P < .05). CONCLUSIONS: Our data indicate that SCA in Saudi patients with high DMFT have a higher predominance of pathogenic bacteria compared to those with low DMFT. Furthermore, SCA in Saudi patients with low fetal haemoglobin have a higher predominance of pathogenic bacteria compared to those with higher fetal haemoglobin.

Sensitivity and Specificity of Rapid SARS-CoV-2 Antigen Detection Using Different Sampling Methods: A Clinical Unicentral Study.

Rapid antigen detection of SARS-CoV-2 has been widely used. However, there is no consensus on the best sampling method. This study aimed to determine the level of agreement between SARS-CoV-2 fluorescent detection and a real-time reverse-transcriptase polymerase chain reaction (rRT-PCR), using different swab methods. Fifty COVID-19 and twenty-six healthy patients were confirmed via rRT-PCR, and each patient was sampled via four swab methods: oropharyngeal (O), nasal (N), spit saliva (S), and combined O/N/S swabs. Each swab was analyzed using an immunofluorescent Quidel system. The combined O/N/S swab provided the highest sensitivity (86%; Kappa = 0.8), followed by nasal (76%; Kappa = 0.68), whereas the saliva revealed the lowest sensitivity (66%; kappa = 0.57). Further, when considering positive detection in any of the O, N, and S samples, excellent agreements with rRT-PCR were achieved (Kappa = 0.91 and 0.97, respectively). Finally, among multiple factors, only patient age revealed a significant negative association with antigenic detection in the saliva. It is concluded that immunofluorescent detection of SARS-CoV-2 antigen is a reliable method for rapid diagnosis under circumstances where at least two swabs, one nasal and one oropharyngeal, are analyzed. Alternatively, a single combined O/N/S swab would improve the sensitivity in contrast to each site swabbed alone.

Medical Conditions, Oral Health Practices, and Barriers to Treatment among Patients Visiting a Teaching Dental Hospital in Eastern Saudi Arabia.

OBJECTIVE: To assess the prevalence of medical conditions, oral hygiene practices, and dental visits among patients who attended a teaching dental hospital in Dammam, Saudi Arabia. Materials & Methods. This retrospective cross-sectional study used patient records from 2009 to 2015 from the dental hospital of the College of Dentistry Imam Abdulrahman Bin Faisal University, Dammam. Patients' demographics, medical history, oral hygiene practices, reasons for attending the facility, attendance patterns, and smoking habits were studied. RESULTS: The study included 1502 records of patients with 65.1% of males and 34.9% of females. The prevalence of medical conditions was 25.7% in the study. The most common medical conditions included diabetes mellitus (7.2%), hypertension (6.5%), and anemia (4.7%). Only 21.8% reported visiting the dental hospital in the past one year. The prevalence of smoking was 16.7%, and this did not differ significantly between healthy and medically compromised patients (P=0.165). Fillings were the most common (21.6%) reason for visiting a dental hospital, followed by treatment for periodontal problems (12.9%) and oral lesions (12.6%), whereas treatment for braces (orthodontics) was the least common (5%) reason for visiting the hospital. The reasons for visiting the hospital did not differ significantly between healthy and medically compromised patients (P > 0.05). The three most common barriers to dental visits included long waiting time (18.1%), fear of dental treatment (14.4%), and difficulty in getting an appointment (11.3%). CONCLUSION: The study showed that dental patients had a high prevalence of medical conditions. Diabetes mellitus was the most prevalent problem. Most patients visited the dental hospital to receive restorative treatment, and a long waiting time was the most common barrier to dental visits. Public health measures should be taken to improve the general health and oral care of patients.

Under-reported COVID-19 cases in South Asian countries.

Background: The purpose of the study was to compare  trends in the progression of COVID-19 among South Asian countries with more developed Western countries. Methods: COVID-19 data from South Asian countries were used for this observational study. Data were taken up to April 21, 2020 from the outbreak of the COVID-19. Four of the seven countries met the inclusion criteria and were included in the analysis. Results: An exponential increase in the average number of weekly cases was reported after the fifth week following the first case. The correlation between reported cases and tests was found to be strong and significant (r=0.90, p=0.037). However, on average, 315.25 tests per million population were performed, which was at least 12 times lower than the number of tests performed in countries with a large number of COVID-19 cases. Conclusions: At present, the number of confirmed cases from South Asia was found to be significantly lower than in Western countries. Hence, an increase in the strength of performing diagnostic tests is highly recommended. Strict measures are required to make the people of these countries follow the instructions of social distancing and comply with preventive measures.

Patient safety culture amongst dental students and interns in Dammam, Saudi Arabia.

OBJECTIVE: To evaluate awareness and attitudes of dental students and interns about patient safety culture in Dammam, Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was conducted on 272 undergraduate dental students and interns using the Safety Attitudes Questionnaire (SAQ) from November 2019 to January 2020. The SAQ consists of six domains: teamwork climate, safety climate, job satisfaction, stress recognition, perception of management and work conditions. The score of SAQ ranges from 0 to 100, and a cut-off ≥75 is considered a positive attitude of patient safety. RESULTS: The study included 47.1% of males and 52.9% of females with a mean age of 22.58 ± 1.3 years. Few participants (9.9%) showed a positive attitude of patient safety culture. Nearly one-third of participants (35.7%) attended a course on patient safety and 31.6% reported experiencing adverse events by them or their families. Out of six domains, job satisfaction showed the highest mean score (70.25) and 75.4% of participants felt proud to practise in the dental clinic. Female students demonstrated a significantly higher mean score of stress recognition (64.28 ± 18.98) than male students (56.98 ± 22.53) (P 0.004). The mean SAQ score increased significantly from fourth year students to interns (P < .001). CONCLUSIONS: A small percentage of students demonstrated a positive attitude of patient safety and only one-third attended a patient safety course. The job satisfaction domain was highly rated and patient safety culture significantly improved from junior to senior students. Dental curricula should include patient safety courses to improve the quality and safety of patient care.

Traumatic dental injuries in the Eastern Region of Saudi Arabia: Factors influencing teachers' management practices.

BACKGROUND/AIMS: Traumatic dental injuries (TDIs) in children frequently occur in schools where teachers can play an important role in their management. Therefore, the aim of this study was to assess schoolteachers' knowledge and the factors that determine their management of TDIs. MATERIALS AND METHODS: This cross-sectional study was conducted in the Eastern Province of Saudi Arabia from January to June 2018. Data were collected through an online pre-tested questionnaire. The questionnaire collected demographic data and included questions that assessed participants' knowledge and management practices for TDI. Chi-square test and multivariate logistic regression analysis were performed. RESULTS: A total of 443 teachers were included in the study, and 72.5% of the participants were females. The prevalence of TDIs was 49% yet only 7.2% of the participants reported managing dental trauma. Fights (22.8%) and falls (21.7%) were the most common causes of dental injuries. Mean TDI knowledge score was 2.75 ± 2.05, but only 47.2% were willing to receive training about TDI management. Regarding supportive environments, 75.8% of teachers reported having safety playgrounds, however 10.6% reported having a nurse in schools. After controlling for other variables, male respondents were 3.85 times more likely to manage TDIs than female respondents (P = .001). Similarly, previous knowledge of dental trauma management (OR = 4.32, P < .001) and having less than 50 students in class (OR = 2.61, P = .021) were significantly associated with TDI management. CONCLUSION: The teachers demonstrated inadequate knowledge about TDIs which were highly prevalent in primary schools. Male gender, having knowledge of TDI management and teaching less students were associated with increased likelihood of TDI management. There is a crucial need for the reinforcement of policies that support school safety and a supportive environment.

Evaluation of Recombinant Human Platelet-Derived Growth Factor or Enamel Matrix Derivative Plus Calcium Hydroxide for Pulp Capping: A Randomized Controlled Human Clinical Trial.

This in vivo study assessed calcium hydroxide's effect as a matrix carrier for recombinant human platelet-derived growth factor (rhPDGF) and enamel matrix protein (EMD) on pulp tissue healing following pulp capping. Intact premolar sites (n = 18) were included. Coronal access and pulpotomy were performed, and each tooth was exposed to the oral cavity for 1 hour before pulp capping was performed. Teeth were randomly assigned to one of the following pulp-capping groups (n = 6 each): Group 1 (CaOH2 only); Group 2 (CaOH2+EMD); and Group 3 (CaOH2+rhPDGF). Coronal access cavities were then sealed. Immediate preoperative, postoperative, and 4-month follow-up radiographs were taken. At 4 months, teeth were extracted atraumatically and histomorphometric and micro-CT analyses were performed. Group 1 showed formation of thin, uneven, highly porous dentin-like structure with tunnel defects (average thickness: 0.18 to 0.19 mm). Lack of continuity of the newly formed tissue and interrupted communication tunnels were seen between the pulpal space and pulp-capping material. Group 2 showed formation of highly dense, nonporous, even-thickness dentin-like structure obliterating multiple areas of the pulp space (average thickness: 0.9 to 0.94 mm). Abundant odontoblast lacunae were present in the pulp and structure. Group 3 showed formation of an inconsistent, uneven dentin-like structure that appeared highly porous (average thickness: 1.04 to 1.05 mm). It was without tunneling, and abundant odontoblastic lacunae were present. No statistically significant differences were found between Groups 2 and 3, but both were richer in newly formed dentin-like structure with more thickness than Group 1 (P < .05). Addition of EMD to CaOH2 can result in multiple root canal calcifications, mostly in the coronal and apical thirds of the canals. The calcified tissue does not appear to resemble secondary dentin in form, shape, amount, or density. Addition of rhPDGF to CaOH2 may not cause root canal calcifications. The newly formed structure differs from secondary dentin in degree of mineralization, porosity, and density.

Dental Facilities During the New Corona Outbreak: A SWOT Analysis.

Recently, there have been many global outbreaks of diseases. The latest is the coronavirus disease of 2019 (COVID-19) pandemic. The virus has spread worldwide and is transmitted mainly through droplets or by touching contaminated surfaces. Globally, healthcare systems are challenged due to a lack of workplace safety and professional obligations in addition to the rapid spread of the virus. Dental facilities are at greater risk due to the nature of dental care. The aim of this review study was to provide a situational analysis within dental facilities during the new COVID-19 outbreak. Published papers concerning dental facilities and COVID-19 were retrieved from PubMed, search engines, and organizational websites. All data were reviewed, arranged into themes, and then categorized either as strengths or weaknesses with respect to addressing the COVID-19 pandemic in dental facilities, and accordingly, threats and possible opportunities to the handling of the pandemic were identified. Preparedness of dental facilities during the current pandemic is a weakness that needs to be addressed promptly. Shortage of dental care providers, cyber security, economic losses, and ethical challenges are possible threats due to the current outbreak. Coordination and prompt communication among all healthcare providers during such outbreaks is a strength that needs to be supported. This strengths, weaknesses, opportunities, and threats (SWOT) analysis can be a useful tool for guiding decision-making as it is crucial during the current pandemic to work on weaknesses, avoid threats, and utilize all future opportunities.

Effect of Photodynamic Therapy, Er,Cr:YSGG, and Nd:YAG Laser on the Push-Out Bond Strength of Fiber Post to Root Dentin.

Objective: To evaluate the push-out bond strength and modes of failure of fiber post to root dentin by using photodynamic therapy (PDT), Er,Cr:YSGG, Nd:YAG laser, and conventional cleaning and shaping (CCS). Materials and methods: Eighty anterior teeth were sectioned in a horizontal manner being 2 mm incisal to the cementoenamel junction, and root canal was prepared for post space. After post space was made, fiber posts were placed inside the root canal system. The fiber posts were subjected to PDT, Er,Cr:YSGG laser, Nd:YAG laser, and conventional cleaning and shaping (CSS) with 20 specimens in each group. Cervical and apical sections were obtained from the specimens. For performing the push-out test, the universal testing machine was used. The formula used for calculating the push-out bond strength was σ = N/mm2. Results: PDT group (8.16 ± 2.19 MPa) achieved the highest mean push-out bond strength, whereas Er,Cr:YSGG (7.24 ± 1.27 MPa) reported the lowest value in the specimens. Among the experimental groups, the ANOVA test expressed statistical difference (p = 0.481). In the cervical segments, the mean push-out bond strength was found to be higher in all of the experimental groups. For the cervical segments, the independent t-test results showed higher mean push-out bond strength values than the apical segments in PDT, Er,Cr:YSGG, Nd:YAG, and CSS groups, respectively (p < 0.05). Twenty failures were observed at the interface level between the adhesive and surface of dentin. Seven failures were found at the interface between mixed and the adhesive and post, respectively. Conclusions: Push-out bond strength to root canal dentin was not affected by PDT, Er,Cr:YSGG, and Nd:YAG laser compared with CCS. However, PDT produced the smallest number of failure modes and slightly higher push-out bond strength to root dentin. Laser treatment using PDT and Er,Cr:YSGG appeared to be clinically efficient showing acceptable push-out bond strength of fiber post with less number of failures at different regions of the root dentin.

Comparison of bacterial removal from dentinal tubules with different irrigant agitation techniques: An in vitro study.

AIM: This investigation was conducted to assess the ability of various irrigant agitation devices to eradicate Enterococcus faecalis from the dentinal tubules of extracted teeth. METHODOLOGY: Fifty roots of extracted human teeth were instrumented to size 30 k with a 0.04 taper. The roots were autoclaved and then injected with E. faecalis. The canals were assigned to one of four intervention groups and disinfected using (A) standard needle irrigation, (B) EndoUltra® Ultrasonic Activator, (C) the EndoActivator system, or (D) EDDY sonic activation and to two control groups that were (E) treated with saline and (F) not inoculated with any bacteria. The roots were split in half, dyed with a LIVE/DEAD Back Light Bacterial Viability Kit, and then scanned with a confocal laser scanning microscope (CLSM) to identify live/dead bacteria in the dentinal tubules. RESULTS: CLSM images revealed differences among the groups. Both the EndoUltra® Ultrasonic Activator group and the EDDY group had a combination of dead and live bacteria, while the EndoActivator group had mostly dead bacteria, in contrast to single needle irrigation which had mostly live bacteria. Activation of the irrigating solution resulted in more dead bacteria than standard needle irrigation at the coronal, middle, and apical parts of the roots. Overall, the EndoActivator system was superior to all other techniques in reducing live bacteria within the root canal. CONCLUSION: Activation of sodium hypochlorite with sonic and ultrasonic systems dramatically reduced live bacteria contamination in the dentinal tubules of infected root canals.

Effect of photodynamic therapy and ErCrYSGG laser irradiation on the push-out bond strength between fiber post and root dentin.

BACKGROUND: To evaluate the push out bond strength and modes of failure of fiber post by using photodynamic therapy (PDT), Er,Cr:YSGG laser and conventional cleaning and shaping (CCS). METHODS: Sixty maxillary anterior teeth were sectioned horizontaly 2 mm incisal to the cemento-enamel junction, and root canal were prepared for post space. Tapered fiber posts were placed inside the root canal after post space was made. The fiber posts were subjected to PDT, Er,Cr:YSGG laser and CSS with 20 specimens in each group. The specimens obtained were sectioned in cervical and apical sections. A universal testing machine was used to perform the push out test and the push out bond strength was formulated by σ = C/A, expressed in mega-pascals (MPa). RESULTS: The highest mean push out bond strength was achieved by PDT group (8.08 ±â€¯2.73 MPa) and the lowest was shown by specimens in CCS group (7.45 ±â€¯1.04 MPa). ANOVA showed no statistical difference among the experimental groups (p = 0.481). In the cervical segments, the mean push-out bond strength was found to be slightly higher for all three groups compared to apical segments (P < 0.05). The independent t-tests results showed that the mean push-out bond strength values of the cervical segments were slightly higher than the apical segments in PDT, Er,Cr:YSGG and CSS groups (P < 0.05). Significant differences were observed when mean push-out bond strengths were compared for both cervical (p = 0.037) and apical (p = 0.019) segments between all the groups. Twenty-one failures were found at the interface between the adhesive and the dentin surface, 6 failures were observed at the interface between the adhesive and post, whereas 5 failures were mixed. CONCLUSION: Push-out bond strength to root canal dentin were not affected by Er,Cr:YSGG compared with conventional cleaning and shaping. However, PDT produced the smallest number of failure modes and slightly higher push-out bond strength to root dentin.

Efficacy of phototherapy in the adhesive bonding of different dental posts to root dentin: A systematic review.

BACKGROUND: The aim of the current systematic review was to evaluate the efficacy of phototherapy in the adhesive bonding of different dental posts to root dentin. METHODS: The outline of this systematic review followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Searches in both electronic and manual literature were performed in the main databases 'MEDLINE' and 'EMBASE' up to March 2019 using the following terms: (Phototherapy) AND (push out test) AND (bond strength) AND (post) OR (fibre) OR (metal) AND (smear layer). RESULTS: Six in-vitro studies were included and processed for data extraction. All studies incorporated the use of fiber posts. The mean shear bond strength for test group ranged from 2.23 to 15.17 MPa while mean shear bond strength for control group ranged from 2.93 to 9.38 MPa. The wavelengths of diode lasers ranged from 660 to 2940 nm (nm). Power was reported in 5 studies ranging from 0.075 W to 3 W. All studies compared shear bond strength of phototherapy in the adhesive bonding of different dental posts to root dentin. In all the included studies, greater bond strength achieved by phototherapy compared to nonirradiated group. CONCLUSION: Within the limits, this study shows that the dentin to post bond strength was significantly enhanced by phototherapy.

Is phototherapy effective in the management of post-operative endodontic pain? A systematic review of randomized controlled clinical trials.

BACKGROUND: The aim of the current review was to answer the P.I.C.O.S question: In patients with post endodontic pain (Population), what is the effect of phototherapy (Intervention) as compared to placebo (Comparator) on post endodontic pain (Outcomes) considering only randomized clinical trials-RCT (Study design)? METHODS: The outline of this systematic review followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Main databases [MEDLINE (1952-February 2019), EMBASE (1984-February 2019), Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register (1993- February 2019)] were searched. PEP was selected as the main outcome variable. The details of the data from the accepted studies were charted according to the research designs, author/country, demographics, involvement of teeth, phototherapy administration, follow-up duration, main results and PEP outcomes. RESULTS: A total of 5 RCTs were included. The wavelengths of diode lasers ranged from 808 to 970 nm. Power output was reported in all the studies ranging from 50 milliwatts (mW) to 5000 mW. All the included studies evaluated PEP after root canal therapy, root canal retreatment or surgical endodontics. Out of the five clinical studies, a total of three studies showed comparable PEP outcome between phototherapy and control groups. However, two studies showed statistically significant improvement in PEP in the phototherapy group as compared to the control group. CONCLUSION: It remains debatable whether phototherapy reduces PEP after root canal therapy. Further robust RCTs with standard laser parameters are warranted to assess the efficacy of phototherapy in the management of PEP.

Current weight of evidence of viruses associated with peri-implantitis and peri-implant health: A systematic review and meta-analysis.

The pathological role of human herpesviruses (HHVs) (Epstein-Barr virus [EBV], Human cytomegalovirus [CMV], and Herpes simplex virus [HSV]) in peri-implant health needs clarification quantitatively. To determine the weight of evidence for HHVs in patients with peri-implantitis (PI) and substantiate the significance of HHVs in peri-implant inflammation, electronic databases including EMBASE, MEDLINE, Cochrane Oral Health Group Trials Register, and Cochrane Central Register of Controlled Trials were searched from 1964 up to and including November 2018. Meta-analyses were conducted for prevalence of HHVs in PI and healthy controls. Forest plots were generated that recorded risk difference (RD) of outcomes and 95% confidence intervals (CI). Five clinical studies were considered and included. Four clinical studies reported data on EBV while three clinical studies reported data on CMV. Considering the risk of these viruses in PI, significant heterogeneity for CMV (χ2  = 53.37, p < 0.0001, I2  = 96.25%) and EBV (χ2  = 14.14, p = 0.002, I2  = 78.79%) prevalence was noticed between PI and healthy control sites. The overall RD for only EBV (RD = 0.20, 95% CI, 0.01-0.40, p = 0.03) was statistically significant between both groups. Frequencies of the viruses were increased in patients with PI compared with healthy nondiseased sites. However, the findings of the present study should be interpreted with caution because of significant heterogeneity and small number of included studies.

The personal human oral microbiome obscures the effects of treatment on periodontal disease.

Periodontitis is a progressive disease of the periodontium with a complex, polymicrobial etiology. Recent Next-Generation Sequencing (NGS) studies of the microbial diversity associated with periodontitis have revealed strong, community-level differences in bacterial assemblages associated with healthy or diseased periodontal sites. In this study, we used NGS approaches to characterize changes in periodontal pocket bacterial diversity after standard periodontal treatment. Despite consistent changes in the abundance of certain taxa in individuals whose condition improved with treatment, post-treatment samples retained the highest similarity to pre-treatment samples from the same individual. Deeper phylogenetic analysis of periodontal pathogen-containing genera Prevotella and Fusobacterium found both unexpected diversity and differential treatment response among species. Our results highlight how understanding interpersonal variability among microbiomes is necessary for determining how polymicrobial diseases respond to treatment and disturbance.

Bacterial flora of dental periradicular lesions analyzed by the 454-pyrosequencing technology.

INTRODUCTION: Symptomatic teeth with periradicular lesions of infectious origin remain a significant challenge in dentistry, and the reason for the acute perturbation is incompletely understood. The present study used pyrosequencing of bacterial 16S ribosomal RNA (rRNA) genes to characterize the microbiota of periradicular lesions. METHODS: Thirteen periradicular lesions from 11 symptomatic and 2 asymptomatic teeth were sampled during apical surgery. Samples were subjected to DNA extraction and 16S rRNA polymerase chain reaction (PCR) amplification. PCR amplicons were then sequenced by using the Roche 454 GS FLX platform. Data were analyzed with the Quantitative Insights into Microbial Ecology (QIIME) software package. RESULTS: Seven of the 13 periradicular lesions (53.8%) yielded PCR amplicons, which generated 35,731 high-quality DNA sequences belonging to 10 bacterial phyla and 73 bacterial genera. All 7 lesions were associated with symptoms. The phyla with most bacterial taxa were Proteobacteria (proportion of total bacterial taxa, 33.3%), Firmicutes (30.9%), Actinobacteria (12.2%), and Bacteroidetes (11.4%). The most abundant genera were Fusobacterium (average of total sequences, 21.0%), Streptococcus (8.0%), Prevotella (7.5%), Corynebacterium (7.2%), Porphyromonas (6.0%). and Actinomyces (5.8%). CONCLUSIONS: This study demonstrated that the microbiota of symptomatic periapical lesions is predominated by anaerobic bacteria but also contains substantial levels of streptococci, actinomyces, and bacteria not previously identified in the oral cavity. The etiopathogenic role and therapeutic implication of periradicular bacteria need to be determined.