Microbiome in maintained periodontitis and its shift over a single maintenance interval of 3 months

Abstract

Aim To assess the subgingival microbial shift of maintained periodontitis treated by ultrasonic scaling (US) or air polishing (AP) during a 3‐month maintenance interval. Materials and methods We conducted a 12‐week randomized split‐mouth controlled trial with US and AP in 17 maintained subjects (bleeding on probing [BOP%] ≤25%, probing depth [PD] ≤5 mm). They were monitored at baseline, week 2, week 8 and week 12. The V3‐V4 region of the 16S rDNA from 136 subgingival plaque samples was sequenced and analysed. Results Treatment by US or AP could effectively reduce the PD, microbial richness, diversity, periodontitis‐associated microbiota and pathogenic metabolism in maintained periodontitis. Bacteria recolonized after treatment and returned to the pre‐treatment level 12 weeks after treatment. Ultrasonic scaling group demonstrated slight advantage in reducing BOP (%), pathogenic bacteria and metabolism than AP group. Pathogenic microbiota and commensal microbiota kept a balance in subgingival community of maintained patients during the 3‐month interval. Conclusions Treatment by US or AP effectively reduced the pathogenicity of subgingival microbiome by reducing microbial diversity, proportion of periodontitis‐associated microbiota and pathogenic metabolism. It helped to keep a balanced subgingival community and stable periodontal condition over a single maintenance interval of 3 months.

Well‐maintained patients with a history of periodontitis still harbor a more dysbiotic microbiome than health

“…Well-maintained subjects with a history of periodontitis were from a longitudinal trial 9 4. BOP (%) ≤ 25%; 5.…”

“…8 Supportive periodontal treatment could effectively remove dental plaque and keep a relatively balanced microbial community. 9 However, many epidemiological studies demonstrated that maintained patients still had a higher risk of recurrence as compared with periodontally healthy individuals. 10,11 It is generally accepted that the challenge of bacteria and host susceptibility are the two main factors accounting for the progress of periodontitis.…”

“…The expected outcome of periodontitis is to eliminate inflammatory response by active periodontal treatment and maintain long‐term periodontal stability with healthy condition 8 . Supportive periodontal treatment could effectively remove dental plaque and keep a relatively balanced microbial community 9 …”

“…It gives us a global view of the subgingival microbial community and provides deep insight into the composition of the oral microbiome, which could help us understand the pathogenesis of subgingival bacteria 14 . A considerable amount of literature has reached an agreement on that subgingival microbiome is a key factor in the maintenance of periodontal condition 9,15 . Balanced community could keep periodontal health; whereas dysbiotic community could trigger periodontitis 16,17 .…”

Salivary Microbiome Shifts in Response to Periodontal Treatment Outcome

“…[ 21 ] Microbial shifts following treatment have also been studied, but with less consistent findings. [ 8,22–24 ] Divergences in the microbial profiles according to the treatment outcome (successful or not) are also not well characterized. [ 25 ]…”