The Neglected Role of Trichomonas tenax in Oral Diseases: A Systematic Review and Meta-analysis

Abstract

Purpose: Trichomonas tenax (T. tenax) is a commensal flagellated protozoan found in periodontal microenvironment of the oral cavity, with a possible role in periodontal diseases. The purpose of the present systematic review and meta-analysis was to determine the worldwide prevalence of T. tenax infection and to show the neglected association of this parasitic infection with oral diseases. Methods: To find literatures published until August 2020, five English databases (PubMed, Scopus, Science Direct, Web of Science and Google Scholar) were explored. Finally, 65 papers were qualified to be included in the current study. Results: Our results revealed a global pooled prevalence of 17% (95% CI 14-22%) for T. tenax infection. The highest prevalence was estimated at 56% (42-69%) in Chile, while the lowest prevalence was related to Kenya with 3% (1-6%). The age-based analysis found that the infection was most common in 46-55 mean age group with 15% (0-100%). The overall prevalence regarding culture method, molecular method and direct method was 21% (12-32%), 19% (8-35%) and 17% (12-23%), respectively. Moreover, the subgroup analysis showed the pooled prevalence in patient with candidiasis [22% (3-52%)], gingivitis [21% (9-36%)] and periodontitis [27% (10-48%)]. Conclusion: Our study specified a connection between T. tenax protozoa and periodontitis disease. However, more epidemiological studies as well as clinical trials are needed to precisely identify this relation.

Oral Colonization by Entamoeba gingivalis and Trichomonas tenax: A PCR-Based Study in Health, Gingivitis, and Periodontitis

“…In periodontitis, the role of the bacterial fraction of the oral microbiome has been studied extensively with accumulating evidence pointing to its contribution to the etiology of the disease ( Teles et al., 2013 ). However, the fraction of protozoa was not studied to a similar level compared to its bacterial counterpart ( Deng et al., 2017 ; Bonner et al., 2018 ; Bisson et al., 2019 ; Santi-Rocca, 2020 ; Badri et al., 2021 ; Eslahi et al., 2021 ). Nevertheless, this protozoan fraction does not seem to be negligible in some clinical setups, with E. gingivalis RNA accounting for up to 9% of the total RNA in periodontal pockets ( Deng et al., 2017 ).…”

“…For T. tenax , the estimates were much lower and significant differences were found moving from 3.2% in the healthy group to 18.2% among individuals with periodontal disease. To assess the reproducibility of these results, a limited number of studies were found ( Kikuta et al., 1996 ; Trim et al., 2011 ; Bonner et al., 2014 ; Garcia et al., 2018a ; Santi-Rocca, 2020 ; Badri et al., 2021 ; Eslahi et al., 2021 ). The comparisons were further complicated by the reliance of a majority of the previous studies on microscopic detection methods (examination of wet mounts or permanent stained smears) ( Athari et al., 2007 ; Ghabanchi et al., 2010 ; Al-hamiary et al., 2011 ; Ibrahim and Abbas, 2012 ; Yazar et al., 2016 ; Hassan et al., 2019 ).…”

“…The role of the yet-identified parasitic fraction of the oral microbiome, namely: Entamoeba gingivalis and Trichomonas tenax , is gaining interest as potential contributing factors to the development of periodontal disease ( Marty et al., 2017 ; Bonner et al., 2018 ; Eslahi et al., 2021 ). Several studies aimed to investigate oral colonization by these parasites among healthy individuals and those with periodontal disease with variable results ( Athari et al., 2007 ; Ghabanchi et al., 2010 ; Al-hamiary et al., 2011 ; Trim et al., 2011 ; Ibrahim and Abbas, 2012 ; Bonner et al., 2014 ; Yazar et al., 2016 ; Hassan et al., 2019 ).…”

Current Global Status and the Epidemiology of Entamoeba gingivalis in Humans: A Systematic Review and Meta-analysis

“…The amoeba has been found scavenging in the healthy oral cavity, but there are still discrepancies regarding the true effect of the E. gingivalis on the hygienic status of the oral cavity (7,8). Some researchers suggest that this organism provokes periodontitis, while others remark that the protozoan is only an opportunistic survivor in the molecular milieu elicited by periodontal disease (9)(10)(11). However, it is recognized that E. gingivalis acts synergistically with symbiotic bacteria to cause periodontal disease in immunocompromised hosts (12).…”

A Loop-Mediated Isothermal Amplification (LAMP) Assay Specific to Trichomonas tenax Is Suitable for Use at Point-of-Care

“…In addition, T. tenax has also been detected in other tissues and organs of the body such as the respiratory tract and lymph nodes [ 6 , 7 , 8 , 9 ]. T. tenax has been reported in humans since the 1960s [ 4 ] and has been specifically connected to human periodontal disease by a systematic review and meta-analysis of 65 qualified publications [ 10 ]. In a prospective study carried out in Jordan recently, it has been found that the prevalence of T. tenax among healthy, gingivitis and periodontitis groups is 3.2%, 5.7% and 25.6%, respectively.…”