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Frontiers in Pharmacology 2021At the initial part of the gastrointestinal tract, multiple tissues serve the normal function of food delivery. Periodontal structures are integral elements of these.... (Review)
Review
At the initial part of the gastrointestinal tract, multiple tissues serve the normal function of food delivery. Periodontal structures are integral elements of these. When they deteriorate, it is extremely challenging to regenerate and reconstruct them. The conventional intervention for periodontal disease is scaling and root planning with the aim of reducing pathogenic bacteria. However, periodontal pathogens can rapidly recolonize treated areas. Probiotics have been proposed as novel tools for managing oral health by suppressing pathogenic bacteria through their anti-inflammatory effect, but the available data are controversial. Therefore, we performed a meta-analysis to study the effect of probiotics on periodontal pathogenic bacteria. The study was registered in PROSPERO under registration number CRD42018094903. A comprehensive literature search from four electronic databases (PubMed, Cochrane CENTRAL, Embase, and Web of Science) yielded nine eligible records for statistical analysis. Studies measuring bacterial counts in saliva and supra- and subgingival plaque were included. Bacterial counts were analyzed using standard mean difference (SMD) and by a random effects model with the DerSimonian-Laird estimation. The results showed a significant decrease in the overall count of in the probiotic-treated group compared to the control at 4 weeks (SMD: -0.28; 95% CI: -0.56--0.01; = 0.045) but not later. Analyzing the bacterial counts in subgroups, namely, in saliva and supra- and subgingival plaque, separately, yielded no significant difference. Probiotics had no significant effect on the overall count of at 4 weeks (SMD: -0.02; 95% CI: -0.35-0.31; = 0.914) or later. Subgroup analysis also revealed no significant difference between treatment and control groups nor did probiotics significantly decrease the overall and subgroup bacterial counts of , , and . Our data support the beneficial effect of probiotics in reducing counts, but not of other key periodontal pathogenic bacteria in periodontal disease patients. However, due to the complex mechanism associated with periodontal disease and the limitations of the available studies, there is a further need for well-designed randomized clinical trials to assess the efficacy of probiotics.
PubMed: 34447307
DOI: 10.3389/fphar.2021.682656 -
Dental and Medical Problems 2021The adjunctive use of fluoroquinolone (FQ) agents in patients with periodontitis produces contradictory results. There has been no meta-analysis performed based on the... (Meta-Analysis)
Meta-Analysis Review
The adjunctive use of fluoroquinolone (FQ) agents in patients with periodontitis produces contradictory results. There has been no meta-analysis performed based on the evaluations of FQ use that would enable making appropriate clinical decisions. Our study aimed to evaluate, via a systematic review and metaanalysis conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, the clinical benefits, antimicrobial effects and safety profiles of the FQ agents administered to periodontitis patients under a conventional treatment regime. Relevant databases were searched for studies published up to May 2020, with the quality and risk of bias evaluations performed on the selected studies, and meta-analyses, funnel plots and heterogeneity tests carried out based on the obtained data. Any finding of p-value less than 0.05 was considered statistically significant. Quality and the risk of bias ranged from high to low. With acceptable heterogeneity and no reporting bias, the meta-analyses showed that local or systemic FQ use produced the following results: a reduced probing depth change (ΔPD) (p < 0.00001 at ≤3 months); reduced bleeding on probing (BOP) (p < 0.00001 at 3-6 months); reduced subgingival detection of Aggregatibacter actinomycetemcomitans for up to 12 months (p-values from <0.00001 to 0.001); and an insignificant number of adverse events (p ≥ 0.05) in patients subjected to a conventional therapy as compared to those subjected to an antibiotic-free therapy. Our study found evidence to show that FQ administration provides clinical benefits and ensures antibacterial effects in periodontitis patients subjected to a conventional therapy regime.
Topics: Anti-Bacterial Agents; Fluoroquinolones; Humans; Periodontitis
PubMed: 34176246
DOI: 10.17219/dmp/133512 -
Microorganisms May 2020This review aimed to systematically compare microbial profiles of peri-implantitis to those of periodontitis and healthy implants. Therefore, an electronic search in... (Review)
Review
This review aimed to systematically compare microbial profiles of peri-implantitis to those of periodontitis and healthy implants. Therefore, an electronic search in five databases was conducted. For inclusion, studies assessing the microbiome of peri-implantitis in otherwise healthy patients were considered. Literature was assessed for consistent evidence of exclusive or predominant peri-implantitis microbiota. Of 158 potentially eligible articles, data of 64 studies on 3730 samples from peri-implant sites were included in this study. Different assessment methods were described in the studies, namely bacterial culture, PCR-based assessment, hybridization techniques, pyrosequencing, and transcriptomic analyses. After analysis of 13 selected culture-dependent studies, no microbial species were found to be specific for peri-implantitis. After assessment of 28 studies using PCR-based methods and a meta-analysis on 19 studies, a higher prevalence of and (log-odds ratio 4.04 and 2.28, respectively) was detected in peri-implantitis biofilms compared with healthy implants. spp., spp. and spp. were found in all five pyrosequencing studies in healthy-, periodontitis-, and peri-implantitis samples. In conclusion, the body of evidence does not show a consistent specific profile. Future studies should focus on the assessment of sites with different diagnosis for the same patient, and investigate the complex host-biofilm interaction.
PubMed: 32369987
DOI: 10.3390/microorganisms8050661 -
Medicine Apr 2020Periodontal bacteria is the major pathogens in the oral cavity and the main cause of adult chronic periodontitis, but their association with incidence and prognosis in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Periodontal bacteria is the major pathogens in the oral cavity and the main cause of adult chronic periodontitis, but their association with incidence and prognosis in cancer is controversial. The aim of this study was to evaluate the effect of periodontal bacteria infection on incidence and prognosis of cancer.
METHODS
A systematic literature search of PubMed, Embase, Web of Science, and Cochrane Library databases was performed to obtain 39 studies comprising 7184 participants. The incidence of cancer was evaluated as odd ratios (OR) with a 95% confidence interval (95% CI) using Review Manager 5.2 software. Overall survival, cancer-specific survival and disease-free survival, which were measured as hazard ratios (HR) with a 95% CI using Review Manager 5.2 software.
RESULTS
Our results indicated that periodontal bacteria infection increased the incidence of cancer (OR = 1.25; 95%CI: 1.03-1.52) and was associated with poor overall survival (HR = 1.75; 95% CI: 1.40-2.20), disease-free survival (HR = 2.18; 95%CI: 1.24-3.84) and cancer-specific survival (HR = 1.85, 95%CI: 1.44-2.39). Subgroup analysis indicted that the risk of cancer was associated with Porphyromonas gingivalis (Pg) infection (OR = 2.16; 95%CI: 1.34-3.47) and Prevotella intermedia (Pi) infection (OR = 1.28; 95%CI: 1.01-1.63) but not Tannerella forsythia (Tf) (OR = 1.06; 95%CI: 0.8-1.41), Treponema denticola (Td) (OR = 1.30; 95%CI: 0.99-1.72), Aggregatibacter actinomycetemcomitans (Aa) (OR = 1.00; 95%CI: 0.48-2.08) and Fusobacterium nucleatum (Fn) (OR = 0.61; 95%CI: 0.32-1.16).
CONCLUSION
This meta-analysis revealed periodontal bacteria infection increased the incidence of cancer and predicted poor prognosis of cancer.
Topics: Aggregatibacter actinomycetemcomitans; Bacterial Infections; Chronic Periodontitis; Disease-Free Survival; Fusobacterium nucleatum; Humans; Incidence; Mouth; Neoplasms; Porphyromonas gingivalis; Prevotella intermedia; Prognosis; Risk Assessment; Treponema denticola
PubMed: 32282725
DOI: 10.1097/MD.0000000000019698 -
Minerva Stomatologica Dec 2018The association between the oral microbiome and periodontal diseases is still unclear. We performed a systematic review and meta-analysis to quantify the association... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The association between the oral microbiome and periodontal diseases is still unclear. We performed a systematic review and meta-analysis to quantify the association between the specific pathogens and periodontitis.
EVIDENCE ACQUISITION
A computerized medical search was performed using MEDLINE and SCOPUS database between 1950 and May 2017 to identify all case-control studies that evaluated the association between specific pathogens and periodontitis. The pooled Odds Ratio with relative 95% confidence interval (95% CI) was calculated and plotted in the forest plot.
EVIDENCE SYNTHESIS
Eleven RCTs involving 2111 patients were included. The retrieved case-control studies evaluated the presence or absence of different targeted pathogens. Among the microrganisms evaluated Porphyromonas gengivalis (OR [95% CI] 2.93 [0.98,8.87]; P<0.0001) and Streptococcus mutans (OR [95% CI] 1.77 [0.89-3.54]; P=0.03) were found to be risk factors for the development of periodontitis, while Aggregatibacter actinomycetemcomitans (OR [95% CI] 0.52 [0.33-0.83]) played a protective role for periodontitis.
CONCLUSIONS
It seems that changes in the taxonomic composition of the microbiome rather than single targeted pathogens is the key determinant of periodontitis.
Topics: Humans; Microbiota; Periodontitis
PubMed: 30207437
DOI: 10.23736/S0026-4970.18.04198-5 -
Orthodontics & Craniofacial Research Nov 2018The aim of this systematic review was to assess qualitative changes induced by fixed appliance orthodontic treatment on the subgingival microbiota. Seven databases were... (Meta-Analysis)
Meta-Analysis
The aim of this systematic review was to assess qualitative changes induced by fixed appliance orthodontic treatment on the subgingival microbiota. Seven databases were searched up to August 2017 for randomized and nonrandomized clinical studies assessing the effect of orthodontic appliances on the subgingival bacteria in human patients. After elimination of duplicate studies, data extraction and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of relative risks (RR) and their 95% confidence intervals (CIs) were performed. According to controlled studies, the presence of Aggregatibacter actinomycetemcomitans in the subgingival crevicular fluid of orthodontic patients was increased 3-6 months after fixed appliance insertion compared to untreated patients (2 studies; RR = 15.54; 95% CI = 3.19-75.85). There was still increased subgingival prevalence of Aggregatibacter actinomycetemcomitans (3 studies; RR = 3.98; 95% CI = 1.23-12.89) and Tannerella forsythia in orthodontic patients up to 6 months after appliance removal compared to untreated patients. However, caution is warranted due to high risk of bias and imprecision. Insertion of orthodontic fixed appliances seems to be associated with a qualitative change of subgingival microbiota, which reverts to some extent back to normal in the first months after appliance removal. However, there is limited evidence on the timing and extent of these changes.
Topics: Aggregatibacter actinomycetemcomitans; Bacterial Load; Databases, Factual; Dental Plaque; Gingiva; Gingival Crevicular Fluid; Humans; Microbiota; Orthodontic Appliances; Orthodontic Appliances, Fixed; Orthodontics, Corrective; Tannerella forsythia
PubMed: 30028077
DOI: 10.1111/ocr.12237 -
Journal of Oral Microbiology 2018: Oral microbiota has been at the center of cultural attention in recent years. In daily clinical practice, orthodontic appliances may be associated with an increased... (Review)
Review
: Oral microbiota has been at the center of cultural attention in recent years. In daily clinical practice, orthodontic appliances may be associated with an increased cariogenic risk and a worsening of preexisting periodontal diseases. : The purpose of this review is to investigate the available evidence regarding the association between orthodontic appliances and changes in the quality and quantity of the oral microbiota. : The research included every article published up to October 2017 featuring the keywords 'Orthodontic appliance* AND (microbiological colonization OR periodontal pathogen* OR OR spp. OR OR OR OR OR OR OR OR )' and was conducted in the major medical databases. The methodological quality of selected papers was scored using the 'Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies' (SBU) method. : Orthodontic appliances influence the oral microbiota with an increase in the counts of and spp. and in the percentage of potentially pathogenic gram-negative bacteria. : There is moderate/high evidence regarding the association between orthodontic appliances and changes in the oral microbiota. PROSPERO registration number CRD42018091589.
PubMed: 29988826
DOI: 10.1080/20002297.2018.1476645 -
Cerebrovascular Diseases Extra 2018To systematically review the current literature investigating the association between oral health and acquired brain injury. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
To systematically review the current literature investigating the association between oral health and acquired brain injury.
METHODS
A structured search strategy was applied to PubMed, Embase, Web of Science, and CENTRAL electronic databases until March 2017 by 2 independent reviewers. The preferred reporting items for systematic review and meta-analysis guidelines were used for systematic review.
RESULTS
Even though the objective was to assess the association between oral health and acquired brain injury, eligible studies focused solely on different forms of stroke and stroke subtypes. Stroke prediction was associated with various factors such as number of teeth, periodontal conditions (even after controlling for confounding factors), clinical attachment loss, antibody levels to Aggregatibacter actinomycetemcomitans and Prevotella intermedia. The literature showed no consensus on the possible association between gingivitis and stroke. Patients with stroke generally had poorer oral hygiene practices and oral health. Dental prophylaxis and professional intervention reduced the incidence of stroke.
CONCLUSIONS
Overall, oral health and stroke were related. Periodontitis and tooth loss were independently associated with stroke. However, prevention and timely intervention may reduce the risk of stroke. Stroke was the main cerebral lesion studied in the literature, with almost no publications on other brain lesions.
Topics: Aggregatibacter actinomycetemcomitans; Bacteroidaceae Infections; Brain Injuries; Cerebrovascular Disorders; Dental Prophylaxis; Female; Gingivitis; Humans; Incidence; Male; Oral Health; Oral Hygiene; Pasteurellaceae Infections; Periodontal Diseases; Periodontitis; Prevotella intermedia; Stroke; Tooth Loss
PubMed: 29402871
DOI: 10.1159/000484989 -
Future Medicinal Chemistry Sep 2017Resistances to antibiotics employed for treatment of infectious diseases have increased to alarming numbers making it more and more difficult to treat diseases caused by... (Review)
Review
AIM
Resistances to antibiotics employed for treatment of infectious diseases have increased to alarming numbers making it more and more difficult to treat diseases caused by microorganisms resistant to common antibiotics. Consequently, novel methods for successful inactivation of pathogens are required. In this instance, one alternative could be application of light for treatment of topical infections. Antimicrobial properties of UV light are well documented, but due to its DNA-damaging properties use for medical purposes is limited. In contrast, irradiation with visible light may be more promising.
METHODS
Literature was systematically screened for research concerning inactivation of main oral bacterial species by means of visible light.
RESULTS
Inactivation of bacterial species, especially pigmented ones, in planktonic state showed promising results. There is a lack of research examining the situation when organized as biofilms.
CONCLUSION
More research concerning situation in a biofilm state is required.
Topics: Aggregatibacter; Anti-Infective Agents; Bacteria; Escherichia coli; Fusobacterium; Humans; Light; Mouth; Porphyromonas; Prevotella; Staphylococcus; Streptococcus
PubMed: 28792235
DOI: 10.4155/fmc-2017-0051 -
Infection & Chemotherapy Dec 2017HACEK is a rare cause of prosthetic valve endocarditis (PVE). We describe 42-year-old male patient who presented with Aggregatibacter aphrophilus PVE and cerebral...
HACEK is a rare cause of prosthetic valve endocarditis (PVE). We describe 42-year-old male patient who presented with Aggregatibacter aphrophilus PVE and cerebral infarct. A. aphrophilus was isolated from his blood cultures as the sole pathogen, which was confirmed by subsequent 16S rRNA sequencing. He was treated with valve replacement surgery and an 8 week course of pathogen-directed antibiotic therapy and followed for 20 months without recurrence.
PubMed: 28608662
DOI: 10.3947/ic.2017.49.4.282