The aim of this study was to estimate differences in the prevalence of oral streptococcal species in the subgingival biofilm of patients with aggressive periodontitis and of healthy controls. Thirty-three patients with clinical and radiological proof of aggressive periodontitis and 20 healthy subjects were enrolled in this study. Clinical indices were recorded in a six-point measurement per tooth. Samples of the subgingival biofilm were taken with paper points from four teeth of each individual. Alpha-and non-haemolytic, small and catalase-negative colonies were biochemically identified using a rapid ID 32 STREP system and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. A total of 118 strains of oral streptococci (11 species) were identified and Streptococcus sanguinis was found significantly more often in healthy subjects (P50.001). Conversely, the absence of S. sanguinis was associated with high values of clinical indices (P50.001-0.002). Aggressive periodontitis seems to be associated with a loss of colonization of S. sanguinis. Whether or not S. sanguinis offers protection against aggressive periodontitis needs to be determined. Otherwise, there were no significant differences in the distribution of oral streptococcal species in patients and healthy subjects.
INTRODUCTIONHealthy gingivae are associated with a simple supragingival biofilm composition: a few (1-20) layers of oral streptococci, Gram-positive rods and very few Gram-negative cocci. These bacteria are early colonizers that are able to survive in an aerated environment. In contrast, clinical gingivitis is associated with the development of a more organized dental plaque of 100-300 layers, with anaerobic Gram-negative rods and filaments being predominant. The species involved in biofilm formation may vary depending on local environmental characteristics, but the colonization pattern is always the same (Marsh & Bradshaw, 1999;Marsh, 2004).Bacterial communities from dental biofilms tend to be grouped in clusters (complexes) according to nutritional and atmospheric requirements. The initiation and progression of periodontitis is thought to be caused by several species belonging to 'red' and 'orange' complexes (Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola, and Prevotella intermedia and Fusobacterium nucleatum, respectively) . However, according to the 'ecological plaque hypothesis ' (Marsh, 1991), the lack of so-called 'protective bacteria' is also thought to play an important role. These are microbial species that can occupy a niche that could shelter pathogenic organisms or that can inhibit some pathogens through metabolic antagonism or by directly inactivating them (Quirynen et al., 2001). Some of the members of the 'yellow' complex of oral streptococci are candidates for this position. Plaque samples from healthy gingival sulci normally contain a large number of oral streptococci (Theilade et al., 1966). Socransky et al. (1998) previously showed that yellow complexes, as a total, were associate...