Predicted functional and taxonomic analysis of subgingival biofilm of Grade C periodontitis in young patients under maintenance therapy

Abstract

Background In Grade C periodontitis in young patients (PerioC‐Y), the functional roles of the subgingival community after years of periodontal treatment are still underexplored. This study evaluated the taxonomic and predicted functional content of the subgingival microbiome of PerioC‐Y patients under supportive periodontal therapy (SPT). Methods Clinical and microbiological data from subgingival biofilm were assessed from 10 PerioC‐Y patients at two time points: at baseline and after 5.7 ± 1.3 years of SPT. This was compared with 15 patients without a history of periodontitis. The V1‐V3 and V4‐V5 regions of the 16S rRNA were sequenced using the Illumina Miseq. Microbial composition was evaluated by the core microbiome, and alpha‐ and beta‐diversity. The microbiome functional content was predicted using Picrust2, and the gene differential abundance was analyzed with DESeq2. Results Clinical improvements were seen in PerioC‐Y‐SPT. Differences in β‐diversity between PerioC‐Y and health were observed (health x PerioC‐Y‐baseline, P = 0.02; health x PerioC‐Y‐SPT, P = 0.05). Moreover, although β‐diversity did not statistically change between baseline and SPT in PerioC‐Y, the microbial correlation evidenced increased Streptococcus and decreased Treponema network contributions during SPT. Based on predicted functional data, treatment induced a reduction in genes related to flagellar protein and signal transduction in PerioC‐Y. However, compared with healthy individuals, some genes remained more highly abundant in PerioC‐Y‐SPT, such as quorum sensing and efflux pump transporters. Conclusion Despite clinical improvements and a shift in taxonomic composition, the PerioC‐Y patients' periodontal treatment was not enough to reach a similar microbiome to patients without disease experience. Some functional content in this biofilm remained altered in PerioC‐Y regardless of disease control.

A randomized double‐blind clinical trial evaluating comparative plaque and gingival health associated with commercially available stannous fluoride‐containing dentifrices as compared to a sodium fluoride control dentifrice

“…[44][45][46] While periodontal health on a reduced periodontium in a periodontitis patient can be reestablished, 46 patients who have a history of periodontitis continue to demonstrate an elevated risk of disease progression and an oral biofilm profile associated with periodontitis. [35][36][37]47,48 These findings highlight the importance of oral hygiene measures aimed at the removal and delayed re-formation of dysbiotic dental biofilm associated with gingivitis, and later, periodontitis to prevent the destructive attachment loss that is characteristic of periodontal disease. 46 Despite the reversible nature of gingivitis and its role as the pathological precursor to periodontal disease, gingivitis prevalence remains high and reported oral home care is suboptimal.…”

“…Gingivitis is a necessary precursor to destructive periodontitis, but not all individuals who develop gingivitis progress to periodontitis, indicating the role of the host immune‐inflammatory response in the development and disease progression of periodontitis 44–46 . While periodontal health on a reduced periodontium in a periodontitis patient can be reestablished, 46 patients who have a history of periodontitis continue to demonstrate an elevated risk of disease progression and an oral biofilm profile associated with periodontitis 35–37,47,48 . These findings highlight the importance of oral hygiene measures aimed at the removal and delayed re‐formation of dysbiotic dental biofilm associated with gingivitis, and later, periodontitis to prevent the destructive attachment loss that is characteristic of periodontal disease 46 …”

“…35,36 Further, in treated individuals with more rapid diseases progression (i.e., Grade C periodontitis), dental biofilm dysbiosis persists even in the absence of clinically detectable signs and symptoms of disease, which may account for the elevated risk of periodontal disease progression. 37 It should be noted that this investigation focused on individuals with gingivitis without a history of periodontitis. Control of supragingival oral biofilm in patients with gingivitis has been shown to be effective in reducing the risk of development of periodontitis, 38 but in individuals with established periodontitis, deep probing depths may serve as a reservoir for dysbiotic microorganisms that could fuel continued periodontal disease activity and progression.…”

“…Despite adequate treatment and ongoing periodontal maintenance, individuals with a history of periodontitis demonstrate an increased risk of periodontal attachment loss and tooth loss over time 35,36 . Further, in treated individuals with more rapid diseases progression (i.e., Grade C periodontitis), dental biofilm dysbiosis persists even in the absence of clinically detectable signs and symptoms of disease, which may account for the elevated risk of periodontal disease progression 37 . It should be noted that this investigation focused on individuals with gingivitis without a history of periodontitis.…”