Actinomycosis as a Rare Local Manifestation of Severe Periodontitis

Abstract

Actinomycosis is a chronic suppurative infection primarily caused by anaerobic gram-positive filamentous bacteria, primarily of the genus Actinomyces. Oral-cervicofacial actinomycosis is the localization found most often, presenting as a soft tissue swelling, an abscess, a mass lesion, or sometimes an ulcerative lesion. Periodontitis-like lesions, however, are rare findings. This report describes the case of a 41-year-old healthy female patient (nonsmoker), who was referred to the clinic with dull and throbbing pain in the second quadrant. Tooth 25 showed increased mobility and probing pocket depths up to 10 mm, with profuse bleeding upon probing. Radiographically, considerable interproximal horizontal bone loss was found, and the diagnosis of periodontitis stage 3, grade C was made. The situation was initially stabilized with adhesive splinting and local anti-infective therapy. Two weeks later, the bone defect was treated with guided tissue regeneration (GTR) using a xenogenic filler material (BioOss Collagen) and a resorbable membrane (Bio-Gide). Due to a suspicious appearance of the excised granulation tissue, the collected fragments were sent for histopathological evaluation. This evaluation revealed a chronic granulomatous inflammation with the presence of filamentous bacterial colonies, consistent with Actinomyces. The patient was successfully treated. While there are only few reports in the literature, actinomycotic lesions represent a rare but possible finding in cases with localized periodontal destruction. In conclusion, systematic biopsy of the infrabony tissue in localized periodontal lesions may help to provide a more accurate counting of Actinomyces-associated lesions, thereby improving diagnosis, therapy, and prevention.

Ultra-high performance liquid chromatography high-resolution mass spectrometry for metabolomic analysis of dental calculus from Duke Alessandro Farnese and Maria D’Aviz

“…With regard to the oral microbiome, some of the compounds detected can also be ascribed to the metabolism of fungi and bacteria. An interesting result is related to the presence of the TMC-34 metabolite deriving from Actinomyces, which are involved in the development of periodontitis 38 – 40 . This metabolite was mainly present in the dental calculus of Maria D’Aviz, and it is known that the noble woman suffered from caries and periodontal diseases 24 .…”

Efficacy of minimally invasive therapy and laser therapy in the comprehensive treatment of endoperiodontal lesions

“…12,13 The use of the drugs containing 17% EDTA in combination with 3% sodium hypochlorite and 3% hydrogen peroxide provides a high degree of cleaning of the walls of the root canals from the smeared layer, which leaves pathogenic microorganisms in the dentinal tubules 'inaccessible.' 14,15 Endodontic treatment may not always be completed immediately with permanent filling in one session. The reason for this is a complex anatomical structure of the root canal system, the presence of a periapical focus of bone tissue rarefaction, especially in endoperiodontal lesions, and destructive forms of periodontitis.…”

TLR2-dependent and independent pyroptosis in dTHP-1 cells induced by Actinomyces oris MG-1

“…Primarily commensals of the human oral cavity, Actinomyces spp., can become pathogenic, especially following a mucosal breach, leading to conditions like cervicofacial actinomycosis. Actinomycosis, periodontitis, and peri-implantitis have shown correlation [ 10 , 11 ]. Moreover, distinguishing actinomycosis from localized aggressive periodontitis and peri-implantitis without pathological examination proves challenging.…”