Newly Identified Pathogens Associated with Periodontitis

Abstract

There is substantial evidence supporting the role of certain oral bacteria species in the onset and progression of periodontitis. Nevertheless, results of independent-culture diagnostic methods introduced about a decade ago have pointed to the existence of new periodontal pathogens. However, the data of these studies have not been evaluated together, which may generate some misunderstanding on the actual role of these microorganisms in the etiology of periodontitis. The aim of this systematic review was to determine the current weight of evidence for newly identified periodontal pathogens based on the results of "association" studies. This review was conducted and reported in accordance with the PRISMA statement. The MEDLINE, EMBASE, and Cochrane databases were searched up to September 2013 for studies (1) comparing microbial data of subgingival plaque samples collected from subjects with periodontitis and periodontal health and (2) evaluating at least 1 microorganism other than the already-known periodontal pathogens. From 1,450 papers identified, 41 studies were eligible. The data were extracted and registered in predefined piloted forms. The results suggested that there is moderate evidence in the literature to support the association of 17 species or phylotypes from the phyla Bacteroidetes, Candidatus Saccharibacteria, Firmicutes, Proteobacteria, Spirochaetes, and Synergistetes. The phylum Candidatus Saccharibacteria and the Archaea domain also seem to have an association with disease. These data point out the importance of previously unidentified species in the etiology of periodontitis and might guide future investigations on the actual role of these suspected new pathogens in the onset and progression of this infection.

Clinical and microbiological parameters of naturally occurring periodontitis in the non-human primate Macaca mulatta

“…oral taxa 280, 281, 365, D. invisus, P. micra, Prevotella spp., S. intermedius , TM7, and several Treponema spp. Although several of the consensus ‘red complex’ periodontal pathogens were present in higher numbers at diseased compared with healthy sites, most of the periodontitis-associated organisms we have identified in macaques have recently been associated with human disease [25]. Taxa present in higher numbers in health included: Actinomyces , Capnocytophaga , Campylobacter , Corynebacterium , Fusobacterium , Leptotrichia , and Propionibacterium .…”

“…This finding suggests that P. gingivalis might not be critical for periodontal pathogenesis in macaques. Indeed, the list of species that have been associated with periodontitis in humans has grown dramatically with the widespread adoption of next-generation sequencing [25]. However, alternative explanations may shed light on this observation.…”

Multiplex real‐time PCR detection and relative quantification of periodontal pathogens

“…Studies have implicated a variety of bacterial species in the development and progression of periodontitis (Perez‐Chaparro et al, 2014). Three of these species, Porphyromonas gingivalis , Tannerella forsythia , and Treponema denticola , are clustered in a group known as the “red complex” (Socransky et al, 1998).…”

Evaluation of Enterococcus faecalis, Staphylococcus warneri and Staphylococcus aureus species in adults with generalized chronic periodontitis

“…Moreover, higher levels of S. warneri were identified in shallow sites of volunteers with disease, in comparison with healthy individuals. This are important data, because a continuous debate in periodontal literature has posed the question asking whether the higher quantity of periodontal pathogens in deep pockets would result only from an overgrowth of these species, favored by the environmental conditions of the periodontal pocket 10 . However, the presence of possible periodontal pathogens in higher levels even in shallow sites of patients with disease contradicted this theory, and constituted an indication of a causal relationship between the presence of the microorganism and onset of infection.…”

“…faecalis and S. aureus have been pointed out as being possible periodontal pathogens in previous studies 10,[12][13] , and S. warneri was recently associated with the etiology of peri-implantitis 14 . However, studies of this type are still scarce, and in general, they do not evaluate sites in different categories of pockets.…”