Role of Suspected Periodontopathogens in Microbiological Monitoring of Periodontitis

Abstract

Periodontal disease is the clinical result of a complex interaction between the host and plaque bacteria. Although a specificity to some degree is found for Actinobacillus actinomycetemcomitans in localized juvenile periodontitis (LJP), it has been difficult to obtain evidence for a specific etiological role of the bacteria associated with periodontal disease in adults. What we see is the net result of host-parasite interactions which in an unpredictable moment accumulate and exceed the threshold of tissue integrity. This hypothesis is concomitant with the view of periodontal disease as a polymicrobial infection, predominantly anaerobic, which occurs commonly in the oral cavity or elsewhere in the body. Some micro-organisms (risk markers) occur more frequently than others and may significantly determine the outcome of this host-parasite interaction. Microbiological sampling and analysis seem to be of limited value in risk assessment; however, they can be used as tools in diagnosis in LJP patients and acute infections, and in treatment decision and therapy control in "refractory" patients. Suspected pathogens (risk markers) are Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and some species of spirochetes, while the roles of Prevotella intermedia, Bacteroidesforsythus, Fusobacterium nucleatum, Campylobacter rectus, and Peptostreptococcus micros are more uncertain. The presence of periodontopathogens as well as enterics, Staphylococcus aureus and Candida especially, should be considered in patients with systemic individual disorders--e.g., diabetes mellitus, neutropenia, agranulocytosis, and AIDS--or with implants.

Cysteine Peptidases of Mammals: Their Biological Roles and Potential Effects in the Oral Cavity and Other Tissues in Health and Disease

“…Immune function in the gingiva in health and disease is in part the result of interactions of cells with antigens, cytokines, and chemokines in complex patterns of production and response that remain to be fully elucidated, but which do not fall clearly into a Th1-or Th2-type response (reviewed in Wilson et al, 1996;Okada and Murakami, 1998;Graves, 1999). Organisms such as P. gingivalis have been identified as potential periodontopathogens, although the infection is distinctly polymicrobial (Dahlén, 1993;Genco, 1996).…”

Interspecies Interactions within Oral Microbial Communities

“…Extensive clinical studies have indicated that the oral microbial flora is responsible for two major human diseases: dental caries (tooth decay) and periodontitis (gum disease) (28,119,128,148,188). For a very long time, oral microbiologists endeavored to use reductionism to identify the key pathogens responsible for oral microbial pathogenesis (43,67,184).…”

Enumeration of Porphyromonas gingivalis, Prevotella intermedia and Actinobacillus actinomycetemcomitans in subgingival plaque samples by a quantitative-competitive PCR method

“…These include cultural methods, microscopy, immuno¯uorescent assays, enzyme-linked immunosorbent assays, trypsinlike protease assays, DNA probes [6] and most recently the PCR [7]. Apart from the latter, all suffer either from lack of speci®city or sensitivity, whereas PCR has been reported to detect as few as 50 cells of P. gingivalis, Pr.…”