Prisustvo oralnih patogenih mikroorganizama u ateromu i trombu pacijenata sa aterosklerozom i infarktom miokarda

Periodontal pockets harbor more than 400 different bacterial species. The aims of this study were to establish new links between periodontitis and atherosclerosis by quantitative and qualitative assessment of periodontal pathogens Аggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythi (Tf) and Treponema denticola (Td) in patient’s mouth and blood vessel. Material and Methods: 100 patients with periodontitis and atherosclerosis were included in the study, divided into 6 groups according to the localization of atheromas and into 2 groups in relation to their age (below and over 60). 13 thrombi from patients with myocardial infarction were analyzed for the presence of oral bacteria and CMV. Pathogen presence and their total load were determined by PCR and real-time quantitative PCR, respectively, and statistically analyzed. Results: 91% of oral samples and 65% of samples of atherosclerotic plaques were positive for at least one of the tested microorganism. Decreasing frequencies of bacteria in oral vs. artery specimens were: Tf (76%:53%), Pi (71%:31%), Pg (60%:38%), Aa (39%:14%) and Td (21%:6%). and their ratio was as follows: Tf 1.4, Pg 1.6, Pi 2.3, Aa 2.8 and Td 3.5. Oral bacteria were the most frequent in coronary arteries. There was no statistical difference in the load of microorganisms between younger and older patients, but Pi and Aa were less frequent in older patients. CMV was more frequent in thrombi than in atheromas. Conclusion: Oral pathogens were found at high frequency in atheroma plaques and thrombi, with a slightly changed bacterial composition compared to oral biofilm. Patient’s age and the distance of a given blood vessel from the mouth influenced microbiological findings.Parodontalni džepovi sadrže više od 400 različitih bakterijskih vrsta i sa ovom studijom se želela ustanoviti nova veza između parodontopatije i ateroskleroze koristeći kvalitativno i kvantitativno određivanje prisustva parodontopatogena Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythi (Tf) i Trepondema denticola (Td) u usnoj duplji i krvnim sudovima pacijenata. Materijal i metode: U ispitivanje je bilo uključeno 100 pacijenata sa parodontopatijom i aterosklerozom, podeljenih u 6 grupa u skladu sa lokalizacijom ateroma i u 2 grupe u odnosu na starost pacijenata (ispod i iznad 60 godina). Analizirano je i 13 trombova od pacijenata sa infarktom miokarda na prisustvo oralnih bakterija i CMV. Detekcija patogena i ukupno opterećenje mikroorganizmima određeni su PCR-om (običnim, odnosno kvantitativnim) a dobijeni podaci su statistički obrađeni. Rezultati: Ispitani mikroorganizmi su bili visoko zastupljeni kako u gingivalnom tako i u aterosklerotskom plaku. Redosled opadajućih učestalosti bakterija u oralnim uzorcima nasuprot ateromima bio je: Tf (76%: 53%), Pi (71%: 31%), Pg (60%: 38%), Aa (39%: 14%) i Td (21%: 6%), a njihov odnos je bio sledeći: Tf 1,4, Pg 1,6, Pi 2,3, Aa 2,8 i Td 3,5. Oralni patogeni bili su najčešći u koronarnim arterijama. Nije bilo značajne razlike u ukupnom sadržaju mikroorganizama između mlađih i starijih pacijenata, ali Pi i Aa su bili češći kod mlađih pacijenata. CMV je bio češći u trombovima nego u ateromima. Zaključak: Oralni patogeni su bili učestali i u ateromima i u trombovima, sa blago izmenjenim sastavom bakterijske zajednice u odnosu na zajednicu u oralnom biofilmu. Mikrobiološki nalaz zavisio je od starosti pacijenta i udaljenosti krvnog suda od usne duplje

The presence of periopathogenic bacteria in subgingival and atherosclerotic plaques- An age related comparative analysis

Introduction: There is a known connection between periodontitis and atherosclerosis and the presence of periopathogens in blood vessels. However, changes of the oral microflora related to the aging process and its possible effects on atherosclerosis, have yet to be analyzed. The aim of this study was to assess temporal changes in the frequency of periodontal bacteria in the subgingival plaque and in atherosclerotic blood vessels of patients with atherosclerosis. Methodology: The study included 100 patients with atherosclerosis and periodontitis, divided into two groups, below and over 60 years of age. Clinical examinations were performedand subgingival plaque specimens were collected as well as biopsy specimens from the following arteries: coronary (34), carotid (29), abdominal (10), femoral (10), mammary (13) and iliac (4). Subgingival and artery specimens were subjected to PCR detection of 5 major periodontal pathogens: Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Aggregatibacter actinomycetemcomitans (Aa), Tannerella forsythensis (Tf) and Treponema denticola (Td). Results: Tf was the most and Td the least frequent bacteria in both age groups and in both types of samples. The frequencies of bacteria in subgingival versus atherosclerotic samples were: Tf (76%: 53%), Pi (71%: 31%), Pg (60%: 38%), Aa (39%: 14%) and Td (21%: 6%). Only Aa and Pi showed a significant difference of prevalence between younger and older patients. The most colonized artery was a. coronaria, followed by a. carotis, a. abdominalis, a. mammaria, and a. femoralis. Conclusions: Patient's age and the distance of a given blood vessel from the oral cavity influenced microbiological findings in the atherotic plaque

Prisustvo oralnih patogenih mikroorganizama u ateromu i trombu pacijenata sa aterosklerozom i infarktom miokarda

Periodontal pockets harbor more than 400 different bacterial species. The aims of this study were to establish new links between periodontitis and atherosclerosis by quantitative and qualitative assessment of periodontal pathogens Аggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythi (Tf) and Treponema denticola (Td) in patient’s mouth and blood vessel. Material and Methods: 100 patients with periodontitis and atherosclerosis were included in the study, divided into 6 groups according to the localization of atheromas and into 2 groups in relation to their age (below and over 60). 13 thrombi from patients with myocardial infarction were analyzed for the presence of oral bacteria and CMV. Pathogen presence and their total load were determined by PCR and real-time quantitative PCR, respectively, and statistically analyzed. Results: 91% of oral samples and 65% of samples of atherosclerotic plaques were positive for at least one of the tested microorganism. Decreasing frequencies of bacteria in oral vs. artery specimens were: Tf (76%:53%), Pi (71%:31%), Pg (60%:38%), Aa (39%:14%) and Td (21%:6%). and their ratio was as follows: Tf 1.4, Pg 1.6, Pi 2.3, Aa 2.8 and Td 3.5. Oral bacteria were the most frequent in coronary arteries. There was no statistical difference in the load of microorganisms between younger and older patients, but Pi and Aa were less frequent in older patients. CMV was more frequent in thrombi than in atheromas. Conclusion: Oral pathogens were found at high frequency in atheroma plaques and thrombi, with a slightly changed bacterial composition compared to oral biofilm. Patient’s age and the distance of a given blood vessel from the mouth influenced microbiological findings.Parodontalni džepovi sadrže više od 400 različitih bakterijskih vrsta i sa ovom studijom se želela ustanoviti nova veza između parodontopatije i ateroskleroze koristeći kvalitativno i kvantitativno određivanje prisustva parodontopatogena Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythi (Tf) i Trepondema denticola (Td) u usnoj duplji i krvnim sudovima pacijenata. Materijal i metode: U ispitivanje je bilo uključeno 100 pacijenata sa parodontopatijom i aterosklerozom, podeljenih u 6 grupa u skladu sa lokalizacijom ateroma i u 2 grupe u odnosu na starost pacijenata (ispod i iznad 60 godina). Analizirano je i 13 trombova od pacijenata sa infarktom miokarda na prisustvo oralnih bakterija i CMV. Detekcija patogena i ukupno opterećenje mikroorganizmima određeni su PCR-om (običnim, odnosno kvantitativnim) a dobijeni podaci su statistički obrađeni. Rezultati: Ispitani mikroorganizmi su bili visoko zastupljeni kako u gingivalnom tako i u aterosklerotskom plaku. Redosled opadajućih učestalosti bakterija u oralnim uzorcima nasuprot ateromima bio je: Tf (76%: 53%), Pi (71%: 31%), Pg (60%: 38%), Aa (39%: 14%) i Td (21%: 6%), a njihov odnos je bio sledeći: Tf 1,4, Pg 1,6, Pi 2,3, Aa 2,8 i Td 3,5. Oralni patogeni bili su najčešći u koronarnim arterijama. Nije bilo značajne razlike u ukupnom sadržaju mikroorganizama između mlađih i starijih pacijenata, ali Pi i Aa su bili češći kod mlađih pacijenata. CMV je bio češći u trombovima nego u ateromima. Zaključak: Oralni patogeni su bili učestali i u ateromima i u trombovima, sa blago izmenjenim sastavom bakterijske zajednice u odnosu na zajednicu u oralnom biofilmu. Mikrobiološki nalaz zavisio je od starosti pacijenta i udaljenosti krvnog suda od usne duplje

Does the Prevalence of Periodontal Pathogens Change in Elderly Edentulous Patients after Complete Denture Treatment?

Purpose: To determine if wearing complete dentures can cause changes in prevalence of some of the most common periodontal pathogens in elderly edentulous patients. The need for understanding the composition of oral microflora in edentulous patients has been recognized by some authors, but no studies have dealt with the changes that occur in periodontal pathogens' prevalence as a result of complete dentures. Materials and Methods: A total of 30 edentulous elderly (average age 71) patients participated in the study. Complete dentures were fabricated for each patient, and the residual alveolar ridges were swabbed before denture insertion. After a period of 6 months swabs were taken again. Identification of P. intermedia, A. actinomycetemcomitans, P. gingivalis, T. forsythia, T. denticola, and F. nucleatum was done by the polymerase chain reaction (PCR) method and primers specific for each microorganism. Results: A noticeable increase in the presence of periodontal pathogens was observed after 6 months of denture wearing; targeted bacteria were identified in 17 pre-insertion samples compared to 28 post-insertion samples. The McNemar test was used to compare the prevalence of periodontal pathogenic bacteria before and after dental treatment. p lt 0.05 indicated statistical significance. Three microorganisms showed a statistically significant difference between the first and second swabbing-A. actinomycetemcomitans (6.7% vs. 40.0%, p = 0.006), P. intermedia (30.0% vs. 73.3%, p = 0.004), and T. forsythia (6.7% vs. 30.0%, p = 0.004). There was also an increase in bacteria co-associations 6 months post-insertion of complete dentures. Conclusions: The results of the present study suggested that wearing complete dentures caused a considerable increase of periodontopathic bacteria prevalence in elderly patients. Better understanding of oral microflora and the impact dental treatment has on bacterial colonies is important in modern dentistry

Ageing with HIV - a periodontal perspective

The importance of oral microflora composition in HIV-infected patients is well recognized. However, no studies so far have dealt with age-related changes in periodontal pathogens occurrence in HIV+ individuals. The aim of the present study was to assess and compare temporal changes of bacteria frequency in younger ( lt = 35 years) and older (>= 50 years) HIV-infected and non-infected individuals. Bacterial DNA was isolated from buccal swabs of 30 younger and 30 older subjects in both HIV+ and HIV-groups. By means of PCR the following microorganisms were detected: Aggregatibacter actinomycetemcomitans, Eikenella corrodens, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola. Oral and periodontal examinations were performed in all subjects. The prevalence of microorganisms was significantly higher in HIV+ patients compared to controls, and their distribution showed a notable shift. The decreasing incidence in HIV-subjects was: Pi>Pm>Pg>Aa>Ec>Tf>Td whilst in HIV+ it was: Pi>Pm>Ec>Pg>Tf>Aa>Td. Oral manifestations of HIV infection were more frequent in older compared to younger patients. All measured values of clinical periodontal parameters were significantly higher in older compared to younger HIV+ patients. Ageing in HIV+ subjects is accompanied with a substantial increase and rearrangements of periodontal microflora, potentially aggravating oral and systemic health