Do patients with aggressive and chronic periodontitis exhibit specific differences in the subgingival microbial composition? A systematic review

Abstract

Background: The 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions grouped the diseases previously recognized as chronic (CP) or aggressive (AgP) periodontitis under a single category named periodontitis. The rationale for this decision was the lack of specific patterns of immuneinflammatory response or microbial profiles associated with CP or AgP. However, no previous studies have compiled the results of all studies comparing subgingival microbial data between these clinical conditions. Thus, this systematic review aimed to answer the following focused question: "Do patients with AgP periodontitis present differences in the subgingival microbiota when compared with patients with CP?" Methods: A systematic review was conducted according to the PRISMA statement. The MEDLINE, EMBASE, and Cochrane databases were searched up to June 2019 for studies of any design (except case reports, case series, and reviews) comparing subgingival microbial data from patients with CP and AgP. Results: A total of 488 articles were identified and 56 were included. Thirteen studies found Aggregatibacter actinomycetemcomitans elevated in AgP in comparison with CP, while Fusobacterium nucleatum, Parvimonas micra, and Campylobacter rectus were elevated in AgP in a few studies. None of these species were elevated in CP. However, the number of studies not showing statistically significant differences between CP and AgP was always higher than that of studies showing differences. Conclusion: These results suggested an association of A. actinomycetemcomitans with AgP, but neither this species nor the other species studied to date were unique to or could differentiate between CP and AgP (PROSPERO #CRD42016039385).

Characterization of the Subgingival Cultivable Microbiota in Patients with Different Stages of Periodontitis in Spain and Colombia. A Cross-Sectional Study

“…However, studies evaluating the composition of the subgingival microbiota have resulted in a high heterogeneity, probably due to the variability in the case definitions used to select periodontitis patients [ 12 ] and sociodemographic or geographic differences [ 9 , 13 ], including differences in ethnicity of the populations evaluated [ 14 ] or in the age [ 15 ]. In fact, previous investigations from our research groups have reported significant differences in the prevalence and proportions of periodontal pathogens when comparing different geographical areas, using the same microbiological diagnostic techniques [ 13 , 16 , 17 , 18 , 19 ].…”

“…Molecular selective techniques, including checkerboard DNA–DNA hybridization, real-time polymerase chain reaction (PCR), human oral microbe identification microarrays (HOMIM), oligonucleotide DNA-DNA hybridization, RNA-oligonucleotide quantification technique (ROQT), and techniques that allow the sequencing of the entire genome, such as pyrosequencing or next-generation sequencing (NGS) [ 7 , 12 ] have contributed to the characterization of periodontal microbiota, but its exclusive use could result in incomplete data on microbial diversity and, therefore, it is important to have parallel culture libraries [ 7 , 20 ]. Despite the fact that molecular detection techniques have greatly contributed to the knowledge of the periodontal microbiota, different studies criticize the total dependence on this type of tests, because they may underestimate a century of culture history.…”

Different scaling and root planing strategies in Turkish patients with aggressive periodontitis: A randomized controlled clinical trial

“…Extensive literature links certain bacterial species to AgP 29 . Although these species are also found on soft oral surfaces, their particular niche is in the subgingival area and their removal/suppression by instrumentation is therefore difficult.…”

“…28 Extensive literature links certain bacterial species to AgP. 29 Although these species are also found on soft oral surfaces, their particular niche is in the subgingival area and their removal/suppression by instrumentation is therefore difficult. Since they belong to the normal oral microbiome, a mere detection of these species may not be as important as their amount.…”

Periodontal pathogens alter the synovial proteome. Periodontal pathogens do not exacerbate macroscopic arthritis but alter the synovial proteome in mice

“…Two oral pathobionts associated PD are Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) [9,10]. While the former has been associated with the pathogenesis of chronic periodontitis in humans, the latter may be related to the severity of the disease [11]. Both came to the fore for their involvement in post translational modification of proteins which has been implicated in the breach of tolerance [12][13][14][15].…”