Investigations of the prevalence and virulence of Candida albicans in periodontal and endodontic lesions in diabetic and normoglycemic patients

Abstract

Pulpal and periodontal tissues have similar microbiota that allows cross-contamination between the pulp and periodontal tissues. Objective The aim of this study was to investigate the prevalence of isolated Candida albicans from periodontal endodontic lesions in diabetic and normoglycemic patients, and the fungi's virulence in different atmospheric conditions.Material and Methods A case-control study was conducted on 15 patients with type 2 diabetes mellitus (G1) and 15 non-diabetics (G2) with periodontal endodontic lesions. Samples of root canals and periodontal pockets were plated on CHROMagar for later identification by polymerase chain reaction (PCR) and virulence test.Results C. albicans was identified in 79.2% and 20.8% of the 60 samples collected from diabetic and normoglycemic patients, respectively. Of the 30 samples collected from periodontal pockets, 13 showed a positive culture for C. albicans, with 77% belonging to G1 and 23% to G2. Of the 11 positive samples from root canals, 82% were from G1 and 18% from G2. Production of proteinase presented a precipitation zone Pz<0.63 of 100% in G1 and 72% in G2, in redox and negative (Pz=1), under anaerobic conditions in both groups. Hydrophobicity of the strains from G1 indicated 16.4% with low, 19.3% with moderate, and 64.3% with high hydrophobicity in redox. In G2, 42.2% had low, 39.8% had moderate, 18% had high hydrophobicity in redox. In anaerobic conditions, G1 showed 15.2% with low, 12.8% with moderate, and 72% with high hydrophobicity; in G2, 33.6% had low, 28.8% had moderate, and 37.6% had high hydrophobicity. There was statistical difference in the number of positive cultures between G1 and G2 (p<0.05) with predominance in G1. There was statistical difference for all virulence factors, except hemolysis (p=0.001).Conclusions Candida albicans was isolated more frequently and had higher virulence in diabetic patients.

Prevalence, virulence and antifungal activity of C. albicans isolated from infected root canals

“…All isolates in our study were strong haemolysin producers but the UAE isolates showed significantly stronger haemolytic activity relative to Finnish endodontic isolates. Interestingly, concurring with our findings, Gomes et al [41], noted that Candida albicans from endodontic lesions in diabetics were more haemolytic than those from normoglycemic individuals.…”

The activity of bacterial peptidylarginine deiminase is important during formation of dual-species biofilm by periodontal pathogen Porphyromonas gingivalis and opportunistic fungus Candida albicans

“…Taking into consideration this hypothesis, it seems appropriate to investigate the significance of PPAD activity to the interactions of P. gingivalis with both the human host and members of biofilm heterogeneous microbial community. Apart from a great variety of bacterial organisms that form dental biofilms, one of the most important fungal pathogens of humans-Candida albicans-has also often been isolated from different locations in the oral cavity, including root canals and deep periodontal pockets (O'Donnell et al 2015;Gomes et al 2017;Marsh and Zaura 2017).…”

Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis

“…This has been attributed to CHX's high diffusibility, substantivity, better effectiveness against resistant microbiota (e.g., Enterococcus faecalis and Candida albicans); its addition to CH also had a positive effect on CH's antimicrobial activity and the medication wettability to dentin [33][34][35]. Diabetic patients have higher incidence rates of Candida-based infections [36], which can be more sensitive to CHX than CH [22,23]. Two of the three studies assessing pain incidence [12,29] included cases with endodontic failure requiring retreatment; endodontic failure cases show a prevalence of Enterococcus faecalis within their microbiota [37].…”