A TEM/SEM study of the microbial plaque overlying the necrotic gingival papillae of HIV‐seropositive, necrotizing ulcerative periodontitis

Abstract

The purpose of this study was to examine by transmission (TEM) and scanning electron microscopy (SEM) the supragingival microbial plaque overlying the ulcerated gingival papillae of necrotizing ulcerative periodontitis (NUP) lesions in HIV-seropositive patients. The microbiota of NUP and HIV-seropositive patients with periodontitis has been reported to be similar to that of conventional periodontitis in non-infected subjects, although several investigators have also reported high recovery rates of microbes not generally associated with the indigenous oral microbial flora. Light and electron microscopic observations and microbial culture studies indicate a similar high prevalence of spirochetes in both necrotizing ulcerative gingivitis (NUG) and NUP. In addition, several studies have reported more frequent isolation of Candida albicans from diseased periodontal sites in HIV-seropositive patients than from non-diseased sites. Ten male and six female patients, each HIV-seropositive and exhibiting NUP, constituted the study population. Two biopsies of involved gingival papillae from between posterior teeth were obtained from each patient and processed for examination by both TEM and SEM. Microscopic examination revealed a surface biofilm comprised of a mixed microbial flora of various morphotypes in 81.3% of biopsy specimens. The subsurface flora featured dense aggregations of spirochetes in 87.5% of specimens. Zones of aggregated polymorphonuclear leukocytes and necrotic cells were also noted. Yeasts were observed in 65.6% of specimens and herpes-like viruses in 56.5% of the specimens. Collectively, except for the presence of yeast and viruses, the results suggest that the microbial flora and possibly the soft tissue lesions of NUP and necrotizing ulcerative gingivitis are very similar.

Xerostomy, dental caries and periodontal disease in HIV+ patients

“…Saliva is one of the most complex, versatile and important fluids of the human body; it includes products of bucal metabolism, bacterial cells, epithelial cells and gingival secretion, which attend to a large spectrum of physiological needs. The presence of structural (mucin, estaterrin, agglutinin, [16][17][18][19][20][21], affirm that the HIV leads to more severe PD disease, which is associated with a deficiency in the response of the host, as the bacterial groups found in the HIV + patients are the same found in HIV -patients. Besides PD, the number of cavities in TG was higher, which occurred because of the reduction of SF and BC of the saliva.…”

Occurrence of yeasts, enterococci and other enteric bacteria in subgingival biofilm of HIV-positive patients with chronic gingivitis and necrotizing periodontitis

“…Moreover, the relevance of immune system in the periodontal tissues protection is documented and the impairment of this system could aggravate periodontal status (6). Associations between periodontal status and presence of the opportunistic infections have not been established, and both gingivitis and periodontitis are often found in symptomatic HIV-patients, where may acquire necrotizing or aggressive characteristics.…”

“…In HIV-positive patients, the occurrence of enteric bacteria and other superinfecting microorganisms and the C. albicans proliferation may also be related to opportunistic viral infections, such as herpesvirus, which are common in these patients producing immunosuppressive factors and cytokines, leading to overgrowth of pathogenic bacteria and fungi (6).…”

Oral Cavity: A Mirror to Hiv Manifestations

“…Yeasts were observed in 65.6% of specimens and herpes-like viruses in 56.5% of the specimens. Collectively, except for the presence of yeast and viruses, the results suggested that the microbial flora and possibly the soft tissue lesions of NUP and NUG are very similar 18 . The prevalence of chronic periodontitis in HIV positive subjects varies considerably from 5 to 69% 20 .…”

“…HIV-associated NUG and NUP were initially considered specific disease conditions. Microbiology there is no major difference between HIV-positive and HIV negative subjects 17,18,19 . A study was done to examine by Transmission Electron Microscope and Scanning Electron Microscope the supragingival microbial plaque overlying the ulcerated gingival papillae of NUP lesions in HIV-seropositive patients.…”