J Periodontal Implant Sci.  2013 Aug;43(4):183-190. 10.5051/jpis.2013.43.4.183.

Quantitative analysis of periodontal pathogens present in the saliva of geriatric subjects

• Shet UK
• Oh HK
• Kim HJ
• Chung HJ
• Kim YJ
• Kim OS
• Choi HR
• Kim OJ
• Lim HJ
• Lee SW

• KMID: 2027814
• DOI: http://doi.org/10.5051/jpis.2013.43.4.183

Abstract

PURPOSE
At present, information regarding periodontal disease in geriatric patients is scarce. The purpose of this study was to quantify the periodontal pathogens present in the saliva of Korean geriatric patients and assess the relationship between the bacterial levels and the periodontal condition.
METHODS
Six putative periodontal pathogens were quantified by using a real-time polymerase chain reaction assay in geriatric patient groups (>60 years) with mild chronic periodontitis (MCP), moderate chronic periodontitis (MoCP), and severe chronic periodontitis (SCP). The copy numbers of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Prevotella intermedia were measured.
RESULTS
It was found that the bacterial copy numbers increased as the severity of the disease increased from MCP to SCP, except for P. intermedia. For P. intermedia, it was found that samples in the MCP group yielded the largest amount. It was also found that the quantities of P. gingivalis, T. forsythia, and T. denticola, the so-called "red complex" bacteria, were lower than those of F. nucleatum, A. actinomycetemcomitans, and P. intermedia in all of the samples.
CONCLUSIONS
Collectively, the results of this study suggest that the levels of P. gingivalis, T. forsythia, F. nucleatum, and T. denticola present in saliva are associated with the severity of periodontal disease in geriatric patients.

Keyword

Chronic periodontitis; Disease progression; Geriatrics; Microbiology; Real-time polymerase chain reaction; Saliva

MeSH Terms

Bacteria
Chronic Periodontitis
Disease Progression
Forsythia
Fusobacterium nucleatum
Geriatrics
Humans
Periodontal Diseases
Porphyromonas gingivalis
Prevotella intermedia
Real-Time Polymerase Chain Reaction
Saliva
Treponema denticola

Figure

• 

  Figure 1 Box plot to describe multiple comparisons between the groups for Log10 copy cell numbers/mL of (A) Porphyromonas gingivalis, (B) Tannerella forsythia, (C) Treponema denticola, (D) Fusobacterium nucleatum, (E) Aggregatibacter actinomycetemcomitans, and (F) Prevotella intermedia. Mild chronic periodontitis (MCP, n=29), moderate chronic periodontitis (MoCP, n=29), and severe chronic periodontitis (SCP, n=30). The box represents the first and third quartiles. The line within the box represents the median value. *Significant difference (P≤0.05). **Significant difference (P≤0.01). ***Significant difference (P≤0.001). CFU: colony forming unit.

Reference

1. Lee R. The outlook for population growth. Science. 2011; 333:569–573.

2. Katz J, Wallet S, Cha S. Periodontal disease and the oral-systemic connection: "is it all the RAGE?". Quintessence Int. 2010; 41:229–237.

3. Dave S, Van Dyke T. The link between periodontal disease and cardiovascular disease is probably inflammation. Oral Dis. 2008; 14:95–101.

4. Williams RC. Periodontal disease. N Engl J Med. 1990; 322:373–382.

5. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005; 366:1809–1820.

6. Paster BJ, Boches SK, Galvin JL, Ericson RE, Lau CN, Levanos VA, et al. Bacterial diversity in human subgingival plaque. J Bacteriol. 2001; 183:3770–3783.

7. Kroes I, Lepp PW, Relman DA. Bacterial diversity within the human subgingival crevice. Proc Natl Acad Sci U S A. 1999; 96:14547–14552.

8. Hunt RJ, Levy SM, Beck JD. The prevalence of periodontal attachment loss in an Iowa population aged 70 and older. J Public Health Dent. 1990; 50:251–256.

9. Gilbert GH, Heft MW. Periodontal status of older Floridians attending senior activity centers. J Clin Periodontol. 1992; 19:249–255.

10. Burt B. Research, Science and Therapy Committee of the American Academy of Periodontology. Position paper: epidemiology of periodontal diseases. J Periodontol. 2005; 76:1406–1419.

11. Boehm TK, Scannapieco FA. The epidemiology, consequences and management of periodontal disease in older adults. J Am Dent Assoc. 2007; 138:Suppl. 26S–33S.

12. Beck JD, Koch GG, Rozier RG, Tudor GE. Prevalence and risk indicators for periodontal attachment loss in a population of older community-dwelling blacks and whites. J Periodontol. 1990; 61:521–528.

13. Kononen E, Jousimies-Somer H, Asikainen S. The most frequently isolated gram-negative anaerobes in saliva and subgingival samples taken from young women. Oral Microbiol Immunol. 1994; 9:126–128.

14. Umeda M, Contreras A, Chen C, Bakker I, Slots J. The utility of whole saliva to detect the oral presence of periodontopathic bacteria. J Periodontol. 1998; 69:828–833.

15. Boutaga K, van Winkelhoff AJ, Vandenbroucke-Grauls CM, Savelkoul PH. The additional value of real-time PCR in the quantitative detection of periodontal pathogens. J Clin Periodontol. 2006; 33:427–433.

16. Boutaga K, Savelkoul PH, Winkel EG, van Winkelhoff AJ. Comparison of subgingival bacterial sampling with oral lavage for detection and quantification of periodontal pathogens by real-time polymerase chain reaction. J Periodontol. 2007; 78:79–86.

17. Morillo JM, Lau L, Sanz M, Herrera D, Silva A. Quantitative real-time PCR based on single copy gene sequence for detection of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. J Periodontal Res. 2003; 38:518–524.

18. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999; 4:1–6.

19. Cogulu D, Oncag O, Kutukculer N, Uzel A, Eronat C. The correlation between serum immunoglobulin A and immunoglobulin G levels and the presence of Treponema denticola in human periapical lesions. J Endod. 2007; 33:1413–1416.

20. Saito D, Coutinho LL, Borges Saito CP, Tsai SM, Hofling JF, Gonçalves RB. Real-time polymerase chain reaction quantification of Porphyromonas gingivalis and Tannerella forsythia in primary endodontic infections. J Endod. 2009; 35:1518–1524.

21. Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998; 25:134–144.

22. Socransky SS, Haffajee AD. Periodontal microbial ecology. Periodontol 2000. 2005; 38:135–187.

23. Marsh PD, Moter A, Devine DA. Dental plaque biofilms: communities, conflict and control. Periodontol 2000. 2011; 55:16–35.

24. Marsh PD. Dental plaque: biological significance of a biofilm and community life-style. J Clin Periodontol. 2005; 32:Suppl 6. 7–15.

25. Tanner AC, Kent R Jr, Kanasi E, Lu SC, Paster BJ, Sonis ST, et al. Clinical characteristics and microbiota of progressing slight chronic periodontitis in adults. J Clin Periodontol. 2007; 34:917–930.

26. van Winkelhoff AJ, Loos BG, van der Reijden WA, van der Velden U. Porphyromonas gingivalis, Bacteroides forsythus and other putative periodontal pathogens in subjects with and without periodontal destruction. J Clin Periodontol. 2002; 29:1023–1028.

27. Holt SC, Ebersole JL. Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia: the "red complex", a prototype polybacterial pathogenic consortium in periodontitis. Periodontol 2000. 2005; 38:72–122.

28. Byrne SJ, Dashper SG, Darby IB, Adams GG, Hoffmann B, Reynolds EC. Progression of chronic periodontitis can be predicted by the levels of Porphyromonas gingivalis and Treponema denticola in subgingival plaque. Oral Microbiol Immunol. 2009; 24:469–477.

29. Saygun I, Nizam N, Keskiner I, Bal V, Kubar A, Acikel C, et al. Salivary infectious agents and periodontal disease status. J Periodontal Res. 2011; 46:235–239.

30. Liljemark WF, Bloomquist C. Human oral microbial ecology and dental caries and periodontal diseases. Crit Rev Oral Biol Med. 1996; 7:180–198.

31. Quirynen M, Van Assche N. Microbial changes after full-mouth tooth extraction, followed by 2-stage implant placement. J Clin Periodontol. 2011; 38:581–589.

32. Yasui M, Ryu M, Sakurai K, Ishihara K. Colonisation of the oral cavity by periodontopathic bacteria in complete denture wearers. Gerodontology. 2012; 29:e494–e502.

33. Darout IA, Albandar JM, Skaug N. Correlations between bacterial levels in autologous subgingival plaque and saliva of adult Sudanese. Clin Oral Investig. 2002; 6:210–216.

34. Consensus report. Periodontal diseases: pathogenesis and microbial factors. Ann Periodontol. 1996; 1:926–932.

35. Socransky SS, Haffajee AD, Smith C, Dibart S. Relation of counts of microbial species to clinical status at the sampled site. J Clin Periodontol. 1991; 18:766–775.