Oral parasitic protozoan Entamoeba gingivalis in periodontal disease patients, northeastern Thailand.

Entamoeba gingivalis is present in the oral cavity of humans and is associated with periodontal disease. Consequently, this study aimed to comprehensively investigate the E. gingivalis infection and the associated risk factors among individuals suffering from periodontal conditions. A cross-sectional descriptive study was carried out within a cohort of periodontal patients. Dental plaque specimens were meticulously collected and subsequently subjected to thorough examination using the polymerase chain reaction (PCR)-based technique targeting the small subunit ribosomal RNA (SrRNA) gene of the organism. The occurrence of risk factors for E. gingivalis infection was analyzed by the chi-square test and binary logistic regression. Out of the 230 participants, 60 were clinically diagnosed with periodontitis, while 170 were afflicted with gingivitis. Out of the 230 patients, 25 (10.9%) tested positive for E. gingivalis infections. An in-depth analysis unveiled that a significant majority of infections were recorded within subgroups characterized by a marital status (15.45%), manifestation of periodontitis (25.00%), and concomitant presence of underlying disease (20.83%). Furthermore, the high risk factor associated with E. gingivalis infection was the female (ORadj = 13.65, 95% CI = 1.08-173.21), followed by periodontitis (ORadj = 3.30, 95% CI = 1.21-9.00), respectively. The study employs a molecular diagnostic approach to screen for E. gingivalis enrichment within a subset of periodontal patients with advancing disease. The findings emphasize the necessity for further research to elucidate the pathogenesis of E. gingivalis and advocate for vigilant surveillance within a substantial population of periodontal patients.

Oral Protozoa Entamoeba Gingivalis And Trichomonas Tenax Among Periodontitis And Gingivitis Patients In Periodontology Department Dental Section Quetta.

Background: A group of eukaryotic organisms that are either free-living or parasitic and feed on organic matter, such as microorganisms or organic detritus. This group is referred to as a polyphyletic classification. They can be found in a wide variety of patterns and sizes, ranging from an amoeba, which can vary its shape, to a paramecium, which has a fixed shape and a complicated structure. The objective was to find out the occurrence of Entamoeba gingivalis and Trichomonas among Dental Patients visiting the Periodontology Department Dental Section, Sandeman, Provincial Hospital Quetta. Methods: The study design was randomized cross-sectional and conducted in the Department of Periodontology Dental Section, Sandeman Provincial Hospital Quetta, from March 2022 to February 2023. A total of 110 known cases of periodontitis and gingivitis were recruited in this study, and further to laboratory work the bacterial biofilm samples were collected from both gingivitis and periodontitis patients. The dental plaque was placed on individual glass microscope slides and a drop of saline and mixed and covered with a coverslip. The wet smear was examined immediately under 40X, and the objective for the presence and absence of motile amoebae or flagellated protozoa was recorded. . Results: out of 110 known cases of periodontitis and gingivitis 91 (83%) patients were males and 19 (17%) were females among 110 patients, 40 (36%) patients were periodontitis and 70 (64%) patients were gingivitis. Among 40 (36%) periodontitis patients 3(7.5%) were Entamoeba gingivalis and 4(10%) were Trichomonas Tenax while 70 (64%) cases of Gingivitis 20 (28%) of Entamoeba gingivalis and 1(1%) Trichomonas tenax was recorded. No patient had both species of protozoa were seen in this study. Conclusion: The results of this study revealed the frequency of occurrence of E. gingivalis and T. tenax and the state of periodontitis and gingivitis. The prevalence of E. gingivalis was higher than T. tenax. We recommended further research with a higher number of patients and may use more advanced and reliable laboratory techniques such as PCR and electron microscopy.

The first study to detect co-infection of Entamoeba gingivalis and periodontitis-associated bacteria in dental patients in Taiwan.

Periodontitis, an inflammatory disease of the oral cavity, was caused by microbes from bacteria to protozoa. In this study, we detected protozoa, Entamoeba gingivalis and other three common pathogenic bacteria, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia by the Polymerase chain reaction (PCR) on patients.

Assessment of the role of Trichomonas tenax in the etiopathogenesis of human periodontitis: A systematic review.

OBJECTIVE: This systematic review was to assess the presence of Trichomonas tenax in patients with periodontitis and to elucidate its potential role in the onset and development of this disease. METHOD: Systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and by consulting the five databases: Medline, Science Direct, Web of Science, Dentistry and Oral Science Sources and Cochrane Central Register of Controlled Trials. Following Koch's postulates revisited by Socransky as PICO framework, this collection data was only including full text of clinical trials concerning patients with periodontitis, case-reports and in vitro research published between 1960 and March 2019. RESULTS: On the 376 studies identified, only 25 fulfilled our eligible criteria. Most of these studies were in vitro research articles designed to evaluate potential virulence factors, and others were clinical trials (case-control studies, randomized controlled trial) and case-reports. The analysis of these papers has shown that i) Trichomonas tenax is more frequently detected in dental biofilm from sites with periodontitis than in healthy sites; ii) this live flagellate seems capable of producing diverse enzymes that could participate in periodontal breakdown and has the capacity to adhere to epithelial cells, its lysed form could induce the synthesis of IL-8 from macrophage cell lines; iii) the impact of non-surgical treatment of periodontitis have not been thoroughly evaluated on the presence of T. tenax. CONCLUSIONS: This systematic review has reported the presence of T. tenax more frequently in diseased than healthy sites and the capacity of this flagellate to synthesis enzymes which could participate to the degradation of periodontal tissues. Nevertheless, these data do not meet all the postulates and are not enough to provide firm conclusions about the role of T. tenax in the etiopathogenesis of periodontitis.

Development of a new TaqMan PCR assay for the detection of both Entamoeba gingivalis genotypes.

Entamoeba gingivalis is a parasitic protozoan found in the mouth of patients suffering from periodontitis, a widespread oral disease with an underestimated prevalence and major consequences on health. We present the development of the first TaqMan PCR assay targeting both E. gingivalis subtypes. This method has been evaluated on 50 samples from patients diagnosed with periodontitis in comparison with 2 different conventional PCRs, and a real-time SYBR Green PCR. Fifty percent of the samples were found positive for the E. gingivalis ST1 subtype with this new PCR, the SYBR Green PCR and one of the conventional PCRs. Among the 25 remaining samples, 12 (24%) were found positive for the E. gingivalis ST2 kamaktlii variant. This new TaqMan PCR could be used before and after periodontitis treatment to follow its efficacy and measure the parasite load in order to better understand the role of these parasites in oral diseases.

Specific clones of Trichomonas tenax are associated with periodontitis.

Trichomonas tenax, an anaerobic protist difficult to cultivate with an unreliable molecular identification, has been suspected of involvement in periodontitis, a multifactorial inflammatory dental disease affecting the soft tissue and bone of periodontium. A cohort of 106 periodontitis patients classified by stages of severity and 85 healthy adult control patients was constituted. An efficient culture protocol, a new identification tool by real-time qPCR of T. tenax and a Multi-Locus Sequence Typing system (MLST) based on T. tenax NIH4 reference strain were created. Fifty-three strains of Trichomonas sp. were obtained from periodontal samples. 37/106 (34.90%) T. tenax from patients with periodontitis and 16/85 (18.80%°) T. tenax from control patients were detected by culture (p = 0.018). Sixty of the 191 samples were tested positive for T. tenax by qPCR, 24/85 (28%) controls and 36/106 (34%) periodontitis patients (p = 0.089). By combining both results, 45/106 (42.5%) patients were positive by culture and/or PCR, as compared to 24/85 (28.2%) controls (p = 0.042). A link was established between the carriage in patients of Trichomonas tenax and the severity of the disease. Genotyping demonstrates the presence of strain diversity with three major different clusters and a relation between disease strains and the periodontitis severity (p<0.05). More frequently detected in periodontal cases, T. tenax is likely to be related to the onset or/and evolution of periodontal diseases.

Reassessing the Role of Entamoeba gingivalis in Periodontitis.

The protozoan Entamoeba gingivalis resides in the oral cavity and is frequently observed in the periodontal pockets of humans and pets. This species of Entamoeba is closely related to the human pathogen Entamoeba histolytica, the agent of amoebiasis. Although E. gingivalis is highly enriched in people with periodontitis (a disease in which inflammation and bone loss correlate with changes in the microbial flora), the potential role of this protozoan in oral infectious diseases is not known. Periodontitis affects half the adult population in the world, eventually leads to edentulism, and has been linked to other pathologies, like diabetes and cardiovascular diseases. As aging is a risk factor for the disorder, it is considered an inevitable physiological process, even though it can be prevented and cured. However, the impact of periodontitis on the patient's health and quality of life, as well as its economic burden, are underestimated. Commonly accepted models explain the progression from health to gingivitis and then periodontitis by a gradual change in the identity and proportion of bacterial microorganisms in the gingival crevices. Though not pathognomonic, inflammation is always present in periodontitis. The recruitment of leukocytes to inflamed gums and their passage to the periodontal pocket lumen are speculated to fuel both tissue destruction and the development of the flora. The individual contribution to the disease of each bacterial species is difficult to establish and the eventual role of protozoa in the fate of this disease has been ignored. Following recent scientific findings, we discuss the relevance of these data and propose that the status of E. gingivalis be reconsidered as a potential pathogen contributing to periodontitis.

Presence of trichomonads in subgingival biofilm of patients with periodontitis: preliminary results.

This study aims to evaluate the prevalence of trichomonads in the subgingival biofilm of patients with periodontitis. Secondarily, the trichomonad presence was related to patient characteristics and periodontal clinical parameters, in order to highlight the factor favoring the development of these protozoans. Subgingival biofilm samples were collected from at least two diseased and one healthy site in 50 patients suffering from periodontitis. Trichomonads were identified using phase contrast microscopy. All patient characteristics and periodontal clinical parameter data were then statistically analyzed. From the 50 patients examined, 195 sites were sampled, including 145 diseased ones. Trichomonads were only observed on 16 of the 145 diseased sites (11%) and none in the other 50 healthy sites. Based on these results, 20% (n = 10) of patients were positive for the presence of trichomonads from at least one of the diseased sites collected. Tooth mobility, substantial supra-gingival dental deposits, and severe clinical attachment loss were statistically associated with trichomonad presence. If the subgingival biofilm of male patients over the age of 50 seemed to be more frequently contaminated with trichomonads, this data was not statistically supported. This preliminary study indicates for the first time that in periodontitis-involved patients, trichomonads are observed in the subgingival biofilm collected from diseased sites with severe bone loss, but not from healthy teeth. Further investigations are needed to fully explore the role of this microorganism in the etiology of periodontal disease.

Fulminant presentation of oral mucosal leishmaniasis as severe stomatitis and periodontitis.

This case report shows an atypical presentation of mucosal leishmaniasis infantum in the oral cavity resulting in severe stomatitis and periodontitis. The patient was immunocompromised because of rheumatoid arthritis for which he used prednisone and methotrexate. He was treated with intravenous liposomal amphotericin B and recovered within four weeks.

Trichomonas tenax and periodontal diseases: a concise review.

Periodontal diseases (gingivitis and periodontitis), result from a disruption of the host-oral microbiome homoeostasis. Whereas the pathological role of some specific bacterial strains during periodontal diseases is well documented, the impact of parasites in periodontium pathophysiology is still under debate. This review aims to collect data about the prevalence and the potential role of Trichomonas tenax during periodontal diseases. Data from 47 studies revealed that T. tenax prevalence in diseased periodontium ranged from 0 to 94·1%. The prevalence of oral protozoan infections was found to be largely greater in patients with periodontal diseases than with healthy periodontium. The parasite detection was mainly performed by direct microscopy. Trichomonas tenax presence was clearly correlated with periodontal disease. The high heterogeneity of its periodontal prevalence may be correlated with the diversity of the population screened (age, sex, systemic diseases), and the methods used for diagnosis. This protozoan seems to have the capacity to be involved in the inflammatory process of gum disease. Animal experimentation, using relevant physiopathological models of periodontitis, needs to be performed to investigate the ability of T. tenax to cause and/or worsen the disease. Further investigations using standardized experimental designs of epidemiologic studies are also needed.

The Prevalence of Canine Oral Protozoa and Their Association with Periodontal Disease.

Periodontal disease is one of the most important health concerns for companion animals. Research into canine forms of periodontitis has focused on the identification and characterization of the bacterial communities present. However, other microorganisms are known to inhabit the oral cavity and could also influence the disease process. A novel, broad spectrum 18S PCR was developed and used, in conjunction with next-generation sequencing analyses to target the identification of protists. Trichomonas sp. and Entamoeba sp. were identified from 92 samples of canine plaque. The overall prevalence of trichomonads was 56.52% (52/92) and entamoebae was 4.34% (4/92). Next-generation sequencing of pooled healthy, gingivitis, early-stage periodontitis, and severe periodontitis samples revealed the proportion of trichomonad sequences to be 3.51% (health), 2.84% (gingivitis), 6.07% (early periodontitis), and 35.04% (severe periodontitis), respectively, and entamoebae to be 0.01% (health), 0.01% (gingivitis), 0.80% (early-stage periodontitis), and 7.91% (severe periodontitis) respectively. Both genera of protists were statistically associated with plaque from dogs with periodontal disease. These findings provide the first conclusive evidence for the presence of oral protozoa in dog plaque and suggest a possible role for protozoa in the periodontal disease process.

The ecological catastrophe of oral diseases: a possible link between periodontitis and protozoa.

Periodontal disease (PD) is one of the prevalent diseases in the adult population. The ethiology of PD has never been completely understood, however, loss of balance between the host immune system and the microbial virulence of PD pathogens may be considered the trigger of PD. In fact, the immune system, activated by microbiological agents, attacks the host and not the biofilm bacteria, causing the destruction of periodontal tissue, alveolar bone and loss of teeth. Parasites may play an important role in the pathology of PD. The first studied and the most common parasite in the oral cavity is Entamoeba gingivalis. A possible link between E. gingivalis and PD has never been demonstrated completely, however E. gingivalis is infrequently found in people without PD. In addition, there is evidence that E. gingivalis could favour the onset and progression of PD. In conclusion, we can assert that E. gingivalis and PD may be correlated. This relationship can open new therapeutical approaches for treating PD, particularly in cases refractory to therapy.

Observation of trichomonads infection in a child with periodontitis by direct microscopy at the dental office.

The pathogenicity of Trichomonas species is well documented. Although their exact involvement in gum disease is not fully understood, recent studies suggest a correlation between these protozoa and periodontitis. This case report details the first chair-side observation in Europe of an oral trichomonad infection in a child with periodontitis, by direct microscopy. The dramatic recovery of the patient, observed following administration of an anti-parasitic treatment, confirms the necessity of further investigation in this field.

Growth kinetics, antigen profiling, and proteinase activity of Egyptian Trichomonas tenax isolates derived from patients having oral infections.

The role of Trichomonas tenax as a pathogen had been clearly implicated in various pathological processes that arise outside the boundaries of the mouth. Although a relationship between the increased occurrence of this protozoan and progression of periodontal disease has been demonstrated, the ability of T. tenax in causing oral infections and the precise mechanism of tissue damage is not well known. The present study aimed to investigate different isolates of T.tenax from individuals having oral infections. Plaques and/or calculi samples were collected from 70 individuals who were diagnosed as having periodontitis and/or gingivitis, then subjected to parasitological examination and culture on modified trypticase, yeast and iron medium (TYI-S-33). Isolates successfully maintained in culture were further subjected to analysis of protein profile of lysates by Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis (SDS-PAGE) and analysis of proteinases by non-denaturing gelatin-SDS-PAGE. Comparison of growth kinetics of seven T. tenax isolates showed a wide variability in the growth characteristics. Protein profiles of the seven isolates revealed a total 53 bands ranged in molecular weight (MW) from 5 to 95kDa using 12% resolution gel. Also, T. tenax isolates were found to possess 19 proteinase bands ranged in MW from 14 to 66kDa. The proteolytic bands were intensified by a cysteine proteinase activator and totally disappeared by treatment with a cysteine proteinase inhibitor suggesting that the proteinases were of cysteine proteinases type. The high frequency of T. tenax detected (28.6%) along with the variability in protein profiling and proteolytic activity of the isolates supports the possible pathogenicity of T. tenax and clarifies a conclusion that different strains with possibility of variable pathogenic potential may exist.

[The investigation of Entamoeba gingivalis and Trichomonas tenax in a group of patients with periodontal disease]. / Periodontal Hastaligi Bulunan Kisilerde Dis Eti Plaklarinda Entamoeba gingivalis ve Trichomonas tenax Arastirilmasi.

The oral cavity is suitable for invasion of many microorganisms. Entamoeba gingivalis (E.gingivalis) and Trichomonas tenax (T.tenax) settle in the oral cavity of patients with poor oral hygiene and gingival disease. In the present study, two slide specimens were prepared from the cole region of the teeth of 46 persons for investigation of the parasites. One of the slide specimens was dried in the air while the other one put into fixative and they were stained with trichrome and Giemsa stains. The two staining methods were used for 36 samples and only Giemsa, for 10 samples. E. gingivalis was positive in 7 (19.44%) out of 36 samples stained by the trichrome stain while T. tenax was positive in one (2.17%) out of 46 samples stained by Giemsa stain. Parasitic infections were found to be positive in seven (21.2%) specimen from 33 patients with periodontal disease and in one (7.69%) specimen from 13 healthy controls. Dental policlinics are generally far from parasitology laboratories and microscopical wet mount examination can not be performed. Therefore dentists can send the specimens and have the parasites diagnosed with Giemsa and trichrome staining methods as an alternative to wet mount examination.

[Invasion of Trichomonas tenax in patients with periodontal diseases]. / Inwazja Trichomonas tenax u pacjentów z chorobami przyzebia.

The aim of the study was to analyze the frequency of occurrence of Trichomonas tenax in patients with periodontitis and also to check the relationship between the occurrence of the protozoan and the indices of oral hygiene, and to evaluate periodontal treatment needs. The study involved 91 individuals aged 23-79 years (52 women and 39 men). 34 of them were infected with Trichomonas tenax. The study revealed dependence between the frequency of occurrence of Trichomonas tenax and the state of periodontium and the hygiene of the oral cavity.

PCR detection of specific Leishmania-DNA in patients with periodontal disease.

This study deals with the detection of Leishmania braziliensis DNA in gingival specimens from 10 individuals who all had suffered from cutaneous leishmaniasis 5-10 years prior to the examination and all had been treated with anti-leishmaniasis drugs. This preliminary study gives an interesting contribution to the oral microbiology of this disease, with the observation that inflamed periodontal tissues can serve as a factor affecting the dispersion of Leishmania parasites in individuals who had suffered from cutaneous leishmaniasis. These finding are corroborated by the results of polymerase chain reaction (PCR) which demonstrated the presence of Leishmania DNA in tissue samples of patients with periodontal diseases.

Entamoeba gingivalis y trichomonas tenax: hallazgo en poblaciones humanas con y sin patología bucal / Entamoeba gingivalis and trichomonas tenax: finding in human populations with and without buccal pathology

Se estudiaron dos poblaciones de 50 pacientes adultos, de ambos sexos, de la ciudad de Rosario: la población 1 (control) con bocas sanas y buenos hábitos de higiene oral y la población 2 con gingivitis y/o periodontitis y mala higiene bucal. El objetivo fue la búsqueda de Entamoeba gingivalis y Trichomonas tenax para determinar sus prevalencias en individuos con patología oral y la relación de estos parásitos con la IgA y pH salival. De cada paciente se obtuvo una muestra de placa y sarro dental y una de saliva, para examen parasitológico por microscopia directa, 100x400 x. Se colorearon frotis de sarro y placa dental con tinción tricrómica para identificación de E. gingivalis. Se determinó además pH e IgA salival. El 50 por ciento de los pacientes con buena salud bucal presentaron parásitos: 20 monoparasitados con E. gingivalis, 1 con T. tenax y los 4 restantes con ambos protozoos. La población con patología bucal presentó un incremento significativo del porcentaje de parasitosis (78 por ciento) con respecto a la anterior, se presentaron 29 individuos monoparasitados con E. gingivalis, 1 con T. tenax y 9 con ambos protozoos. La frecuencia de E. gingivalis y T. tenax en la población 1 fueron 48 por cienbto y 10 por ciento respectivamente y resultaron notablemente mayores en la población 2 (E. gingivalis 76 por ciento y T. tenax 20 por ciento). Los hallazgos de protozoos en las dos poblaciones predominaron en placa y sarro dental. La utilización de la técnica de tinción tricrómica de Gomori aumentó la posibilidad de diagnóstico en ambas poblaciones. La presencia de parásitos orales fue independiente del valor de IgA en las dos poblaciones. La población control presentó dependencia entre el pH salival y la presencia de protozoos y se podría inferir que el pH ligeramente ácido favorece la colonización parasitaria. En la población con patología bucal no habría dependencia entre estas variables. La alta frecuencia encontrada de estos protozoos en pacientes con gingivitis y/o periodontitis destaca la importancia del diagnóstico para aplicar el tratamiento específico que permite la erradicación parasitaria

Entamoeba gingivalis y trichomonas tenax: hallazgo en poblaciones humanas con y sin patología bucal / Entamoeba gingivalis and trichomonas tenax: finding in human populations with and without buccal pathology

Se estudiaron dos poblaciones de 50 pacientes adultos, de ambos sexos, de la ciudad de Rosario: la población 1 (control) con bocas sanas y buenos hábitos de higiene oral y la población 2 con gingivitis y/o periodontitis y mala higiene bucal. El objetivo fue la búsqueda de Entamoeba gingivalis y Trichomonas tenax para determinar sus prevalencias en individuos con patología oral y la relación de estos parásitos con la IgA y pH salival. De cada paciente se obtuvo una muestra de placa y sarro dental y una de saliva, para examen parasitológico por microscopia directa, 100x400 x. Se colorearon frotis de sarro y placa dental con tinción tricrómica para identificación de E. gingivalis. Se determinó además pH e IgA salival. El 50 por ciento de los pacientes con buena salud bucal presentaron parásitos: 20 monoparasitados con E. gingivalis, 1 con T. tenax y los 4 restantes con ambos protozoos. La población con patología bucal presentó un incremento significativo del porcentaje de parasitosis (78 por ciento) con respecto a la anterior, se presentaron 29 individuos monoparasitados con E. gingivalis, 1 con T. tenax y 9 con ambos protozoos. La frecuencia de E. gingivalis y T. tenax en la población 1 fueron 48 por cienbto y 10 por ciento respectivamente y resultaron notablemente mayores en la población 2 (E. gingivalis 76 por ciento y T. tenax 20 por ciento). Los hallazgos de protozoos en las dos poblaciones predominaron en placa y sarro dental. La utilización de la técnica de tinción tricrómica de Gomori aumentó la posibilidad de diagnóstico en ambas poblaciones. La presencia de parásitos orales fue independiente del valor de IgA en las dos poblaciones. La población control presentó dependencia entre el pH salival y la presencia de protozoos y se podría inferir que el pH ligeramente ácido favorece la colonización parasitaria. En la población con patología bucal no habría dependencia entre estas variables. La alta frecuencia encontrada de estos protozoos en pacientes con gingivitis y/o periodontitis destaca la importancia del diagnóstico para aplicar el tratamiento específico que permite la erradicación parasitaria (AU)

Periodontal aspects of the juvenile form of paracoccidioidomycosis.

Three cases of the juvenile form of paracoccidioidomycosis are reported. Emphasis has been given to the oral manifestations, particularly the periodontal involvement. The main periodontal findings were: generalized and progressive alveolar bone destruction leading to gingival recession with exposure of the tooth roots, and spontaneous tooth losses. The gingival mucosa was predominantly smooth, erythematous and slightly swollen. These aspects, although rare, may be the earliest signs of the disease and sometimes its only manifestations.