Study of oral microorganisms contributing to non‐carious cervical lesions via bacterial interaction and pH regulation

Abstract

There is a lack of evidence about the relationship between microorganisms and non‐carious cervical lesions (NCCLs) due to limited technologies. A group of 78 patients was enrolled for microbial 16S rRNA sequencing of dental plaques on normal and defective cervical surfaces. Parallel data from 39 patients were analysed with paired t tests, and Fusobacteriales exhibited significantly less distribution on NCCLs than on normal surfaces. As a result, Fusobacterium nucleatum, the most common oral bacterial strain belonging to the order Fusobacteriales, was selected for further research. From a scanning electron microscopy (SEM) scan, the tooth surface with Fusobacterium nucleatum and Streptococcus mutans culture was more intact than that without Fusobacterium nucleatum. Furthermore, the calcium contents in groups with Fusobacterium nucleatum were significantly higher than that without it. In further mechanistic research, Fusobacterium nucleatum was demonstrated to adhere to and disturb other organisms as well as producing alkaline secretions to neutralize the deleterious acidic environment, protecting the tooth structure. In conclusion, microorganisms and NCCLs were confirmed directly related through adherent bacterial interactions and pH regulation. The research provides a new perspective and experimental evidence for the relation between microorganisms and NCCLs, which guides clinical treatment and preventive dentistry in the future.

Morphological and Optical Coherence Tomography Aspects of Non-Carious Cervical Lesions

“…From 2018 to now, more than 150 studies have been published in PubMed indexed journals regarding this form of dental wear. Most of the studies focused on the etiology of NCCLs [ 43 , 44 , 45 , 46 ], but there is currently no established consensus regarding this of for potential treatments, due to the frequent failures recorded in the practical studies [ 4 , 47 , 48 , 49 ].…”

Noncarious cervical lesions: Morphology and progression, prevalence, etiology, pathophysiology, and clinical guidelines for restoration

“…An NCCL has a multifaceted etiology that draws on the same mechanisms for demineralization, but in a unique pattern that is specific for each tooth. Patients may have multiple NCCLs but each one is not quite the same manifestation as the others 78,79 . Only one tooth may be affected and bilateral symmetry is rare.…”

“…Demineralization is a broad‐spectrum disease that has both an infectious and noninfectious etiology 3,77 . Cariogenic bacteria do not contribute to NCCLs, but other oral microorganisms such as Fusobacteriales may protect a cervical lesion from acidic degradation via bacterial interaction (interference) and pH regulation 78 . Equilibrium of demineralization and remineralization in the presence of optimal fluoride decreases caries prevalence, 3,77 but the effect on NCCLs is unknown.…”

“…Patients may have multiple NCCLs but each one is not quite the same manifestation as the others. 78,79 Only one tooth may be affected and bilateral symmetry is rare.…”

“…3,77 Cariogenic bacteria do not contribute to NCCLs, but other oral microorganisms such as Fusobacteriales may protect a cervical lesion from acidic degradation via bacterial interaction (interference) and pH regulation. 78 Equilibrium of demineralization and remineralization in the presence of optimal fluoride decreases caries prevalence, 3,77 but the effect on NCCLs is unknown. Fluoride is an essential trace element with multiple health benefits, but fluorosis disrupts cell physiology via modifications of apoptosis, stress, and signaling.…”