Inflammatory and immune pathways in the pathogenesis of periodontal disease (original) (raw)
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Oral microbiota and systemic disease
Anaerobe, 2013
It is well known that bacteria are the primary cause of infectious diseases, however, evidence is emerging that these organisms are also indirectly responsible for several diseases including cancer and rheumatoid arthritis. The oral cavity is home to several million bacteria that can cause two major diseases-periodontitis and caries. The relationship between periodontopathic bacteria and systemic diseases has been explored for several years. The concept of the oral cavity as a source of distant infection has been debated for at least a century. This review will discuss the historic aspects of the development of the focal infection theory, the reasons for its demise, its re-emergence and current status.
Periodontal Microbes and Immunity
Knowledge of how immune mechanisms and inflammatory responses are regulated is critical for understanding the pathogenesis of complex diseases, such as periodontitis. The pathogenesis of periodontal disease is mediated by the inflammatory response to bacteria in the dental biofilm. Unlike many infectious diseases, periodontal diseases appear to be infection mediated by the overgrowth of commensal organisms rather than by acquisition of an exogenous pathogen. Recent advances in cellular and molecular biology research have demonstrated the importance of the acquired immune system not only in fighting the virulent periodontal pathogens, but also in protecting the host from developing further devastating condition in periodontal infections. Three basic mechanisms have been postulated to play a role in these interactions; metastatic infections, inflammation and inflammatory injury, and adaptive immunity. The potential role of each alone and together is considered in, in vitro and animal studies and in human studies when available. The present review is intended tohighlight the emerging role of neutrophil extracellular trap production in the regulation of immune response andits role in periodontal disease.
Relationship between oral microbiota and periodontal disease: a systematic review
PubMed, 2018
Objective: In recent years metagenomic analysis has become more accessible for the characterization of biological specimens. There has been an important increase of studies using this technique for subgingival human samples. To date, there are no updated systematic reviews on the relationship between oral microbiota and periodontal disease. The aim of the present systematic review was to update data about studies concerning the influences of changes in oral microbiota composition on the periodontal status in human subjects. Materials and methods: An electronic search was conducted in four databases (MEDLINE, Scopus, CENTRAL and Web of Science) for articles published in English from January 2014 to April 2018. In vitro or animal studies, case reports, case series, retrospective studies, review articles, abstracts and discussions were excluded. Also, studies that evaluated less than 5 microbial species, only viruses or already known periodontal pathogens were excluded. Two independent researches selected the studies and extracted the data. The quality of evidence was assessed as high, moderate or low for each microorganism. Results: Eight studies and three additional publications recovered from the bibliography search of the selected articles were included in the review. The Bacteria domain was the main detected among the others and it included 53 species. The review confirmed the presence of recognized periodontal pathogens such as the members of the red complex but also identified, with high weight of evidence, the presence of new pathogens. Conclusions: The results of this systematic review support high evidence for the association of 3 new species/genera with the etiology of periodontitis. Future investigations on the actual role of these new pathogens in the onset and progression of the disease are needed.
The Journal of physiology, 2016
The oral microbiome is established within a few minutes after birth and consists of stable multi-species communities that engage in a dynamic equilibrium with the host immune system. Dental caries, endodontic infections and periodontal diseases are bacterially driven diseases that are caused by dysbiotic microbiomes. Over a century ago, the focal infection theory implicated these infections in the aetiology of several systemic diseases, ranging from arthritis to neurodegenerative diseases. However, a lack of concrete evidence, combined with the urgency with which clinicians embraced this approach without regard for appropriate case selection, led to its demise within 30 years. In the last decade of the 20th century, the concept of periodontal medicine was introduced to explain the correlations that were being observed between periodontitis and cardiovascular disease, rheumatoid arthritis, Alzheimer's disease, pulmonary disease, pre-term delivery of low birth weight infants and m...
Journal of Stomatology
In 2005 a broad scale project on human microbiome research (the Human Microbiome Project-HMB) was initiated. Its aim was to research the composition of the microflora of the human body, and create a genome database of microorganisms existing on the human body surface and having contact with the external environment. The scope of the project involved examining oral microbiomes of 250 healthy individuals at reproductive age. As a result, an extensive database of bacterial genomes was created and variabilities dependent on the examined environment, race, sex, ethnicity, and eating habits were determined. The aim of this paper is to present the contemporary state of knowledge on the composition of micro organisms populating the human body with a special emphasis placed on the composition of oral microflora and subgingival biofilm, and including comments regarding phylogenetic adaptation of humans to life in the world of microorganisms. Contemporary methods of microorganism identification significantly broaden our knowledge on the composition of microflora in various biotopes, and correlations of microorganisms in different ecosystems as well as among each other. However, the knowledge is still fragmented and fails to provide a firm basis to introduce advantageous and permanent changes in the microbiome. Yet, it allows for verifying some hitherto accepted theories regarding the role of bacteria in health and sickness. Thanks to the above, in periodontology views on etiopathogenesis of periodontitis have been changing. The contemporary state of knowledge on the human oral microbiome is becoming broader and broader. It may lead to discussions about changing some hypotheses regarding the role bacteria play in periodontitis; however, there are too many unknowns to provide bases for pharmacological or biological changes in its composition.
The Presence of Bacteria in the Oral Epithelium in Periodontal Disease
Journal of Periodontology, 1987
Langerhans cells (LC) are cell types found in the skin and gingiva. LC have immunological functions as phagocytic cells and as antigen-presenting cells for and lymphocytes. Sections from biopsies of the gingiva in cases of periodontal disease were found to have increased numbers of LC. These biopsies also contained intragingival bacteria. Serial sections of frozen specimens of human gingiva were prepared for staining. Hematoxylin and eosin were used for tissue survey, the Gram stain for assessment of bacterial invasion, anti-Leu-6 monoclonal antibody associated with peroxidase technique (PAP) to identify LC, antibacterial sera to Bacteroides gingivalis and Actinobacillus actinomycetemcomitans associated with peroxidase to specifically identify these two common periodontopathogenic bacteria. Additional positive identification of bacteria was performed by preparing the same histological section containing gram-stained particles for scanning electron microscope and transmission electron microscope LC confirmation. The results suggest that the increased number of LC seen in diseased sites of oral epithelium containing intragingival microorganisms may be one of the host immune mechanisms to penetration by bacteria.