The Associations of Periodontopathic Bacteria and Oral Candida with Periodontal Inflamed Surface Area in Older Adults Receiving Supportive Periodontal Therapy

Abstract

The periodontal inflamed surface area (PISA) has been proposed for assessment of the total periodontal inflammatory status in people with periodontitis. This study was performed to investigate the associations of periodontopathic bacteria and candida with PISA in older people. We enrolled 100 patients aged ≥ 60 years who visited Hiroshima University Hospital. PISA and periodontal epithelial surface area (PESA) were calculated in each patient. Oral rinse samples were collected for DNA extraction. Periodontopathic bacteria and candida were detected by polymerase chain reaction. The mean values of PISA and PESA were significantly greater in T.forsythia-positive patients than in T.forsythia-negative patients. T.forsythia/C. albicans double-positive patients exhibited significantly greater PISA values than did non-double-positive patients. Additionally, PISA values were significantly greater in T. forsythia//T. denticola/C. albicans triple-positive patients than in T. forsythia//T. denticola/C. albicans non-triple-positive patients (p = 0.02). Propensity score-matching was performed between periodontopathic bacteria-positive and -negative patients using propensity scores generated from clinical factors. Importantly, T.forsythia/T. denticola double-positive patients exhibited significantly greater PISA values than non-double-positive patients among 72 propensity score-matched patients. Our preliminary results highlight the importance of the presence of T.forsythia and T. denticola for periodontal inflammation severity in older Japanese people.

Co-Infection of Oral Candida albicans and Porphyromonas gingivalis Is Associated with Active Periodontitis in Middle-Aged and Older Japanese People

“…The results highlight the importance of co-infection with red complex bacteria in periodontal inflammation severity. In contrast, no significant association was found between P. gingivalis and PISA values in participants after adjustment for their potential confounding factors [25]. Thus, P. gingivalis may determine the severity of periodontitis in cooperation with other periodontopathic pathogens such as C. albicans.…”

“…The relationship between periodontopathic bacteria and PISA values was previously investigated in participants after adjustment for their potential confounding factors using propensity scores [25]. Participants with co-infection of Tannerella forsythia and Treponema denticola exhibited significantly higher PISA values than those without such co-infection [25].…”

Cross-kingdom Microbial Interactions Within the Oral Cavity and Their Implications for Oral Disease

“…albicans has been co-located with periodontopathogens such as Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola in sites of periodontitis. Importantly, periodontal sites from which the fungus was co-isolated with either T. forsythia or T. denticola appeared to display a greater surface area of inflammation, suggesting a synergism between the bacteria and fungus triggering periodontal tissue damage [13]. Of all the periodontal bacterial pathogens, the interactions between P. gingivalis and C. albicans have been explored in most depth.…”

In it together: Candida–bacterial oral biofilms and therapeutic strategies

“…Lately, the role of yeast and its crosskingdom interaction with various bacteria in periodontitis pathogenesis were discussed. Investigation of the associations of Candida and periodontopathic bacteria from seniors (≥60 years old) demonstrated that the surface area of inflamed periodontal tissue was significantly greater when T. forsythia and T. denticola were detected together with C. albicans from patients (Shigeishi et al, 2021). Also, several studies revealed various interaction mechanisms between C. albicans and P. gingivalis.…”