Periodontitis and alveolar resorption in human skeletal remains: The relationship between quantitative alveolar bone loss, occlusal wear, antemortem tooth loss, dental calculus and age at death in a low socioeconomic status, modern forensic human collection from Yucatan.

OBJECTIVE: This paper assesses the relationship between the distance between the cemento-enamel junction and alveolar crest and risk factors commonly associated with periodontitis. MATERIALS: Eighty individuals between 28 and 92 years old with known biological sex and age were analyzed from a 20th century forensic human collection from Merida, Yucatan (Mexico). METHODS: Macroscopic assessment, along with metric analysis, was employed using a probe. RESULTS: Ante-mortem tooth loss was positively correlated with the distance between the cemento-enamel junction and alveolar crest, as was the presence of root calculus in females. CONCLUSIONS: Cemento-enamel junction to alveolar crest distance is not a reliable indicator of periodontitis since it is not directly related to periodontitis-causing infectious pathogens, and since ante-mortem tooth loss can affect root exposure. SIGNIFICANCE: This study demonstrates that a purely quantitative approach to diagnosing periodontitis in archaeological and forensic human remains can be misleading. LIMITATIONS: The skeletal collection is only representative of the low socioeconomic class of Merida, and its female cohort is underrepresented. In addition, because the Xoclan collection is modern, limitations (particularly with respect to tooth wear) of the applicability of these interpretations to older archaeological remains exist. SUGGESTION FOR FURTHER RESEARCH: A combination of quantitative and qualitative characteristics of alveolar bone is needed to reliably diagnose periodontitis in skeletal populations.

Comparison of Periodontal Bacteria of Edo and Modern Periods Using Novel Diagnostic Approach for Periodontitis With Micro-CT.

Ancient dental calculus, formed from dental plaque, is a rich source of ancient DNA and can provide information regarding the food and oral microbiology at that time. Genomic analysis of dental calculus from Neanderthals has revealed the difference in bacterial composition of oral microbiome between Neanderthals and modern humans. There are few reports investigating whether the pathogenic bacteria of periodontitis, a polymicrobial disease induced in response to the accumulation of dental plaque, were different between ancient and modern humans. This study aimed to compare the bacterial composition of the oral microbiome in ancient and modern human samples and to investigate whether lifestyle differences depending on the era have altered the bacterial composition of the oral microbiome and the causative bacteria of periodontitis. Additionally, we introduce a novel diagnostic approach for periodontitis in ancient skeletons using micro-computed tomography. Ancient 16S rDNA sequences were obtained from 12 samples at the Unko-in site (18th-19th century) of the Edo era (1603-1867), a characteristic period in Japan when immigrants were not accepted. Furthermore, modern 16S rDNA data from 53 samples were obtained from a database to compare the modern and ancient microbiome. The microbial co-occurrence network was analyzed based on 16S rDNA read abundance. Eubacterium species, Mollicutes species, and Treponema socranskii were the core species in the Edo co-occurrence network. The co-occurrence relationship between Actinomyces oricola and Eggerthella lenta appeared to have played a key role in causing periodontitis in the Edo era. However, Porphyromonas gingivalis, Fusobacterium nucleatum subsp. vincentii, and Prevotella pleuritidis were the core and highly abundant species in the co-occurrence network of modern samples. These results suggest the possibility of differences in the pathogens causing periodontitis during different eras in history.

Paleogenomic insights into the red complex bacteria Tannerella forsythia in Pre-Hispanic and Colonial individuals from Mexico.

The 'red complex' is an aggregate of three oral bacteria (Tannerella forsythia, Porphyromonas gingivalis and Treponema denticola) responsible for severe clinical manifestation of periodontal disease. Here, we report the first direct evidence of ancient T.forsythia DNA in dentin and dental calculus samples from archaeological skeletal remains that span from the Pre-Hispanic to the Colonial period in Mexico. We recovered twelve partial ancient T. forsythia genomes and observed a distinct phylogenetic placement of samples, suggesting that the strains present in Pre-Hispanic individuals likely arrived with the first human migrations to the Americas and that new strains were introduced with the arrival of European and African populations in the sixteenth century. We also identified instances of the differential presence of genes between periods in the T. forsythia ancient genomes, with certain genes present in Pre-Hispanic individuals and absent in Colonial individuals, and vice versa. This study highlights the potential for studying ancient T. forsythia genomes to unveil past social interactions through analysis of disease transmission. Our results illustrate the long-standing relationship between this oral pathogen and its human host, while also unveiling key evidence to understand its evolutionary history in Pre-Hispanic and Colonial Mexico. This article is part of the theme issue 'Insights into health and disease from ancient biomolecules'.

Prevalence and severity of periodontal disease in a historical Austrian population.

OBJECTIVE: To assess the prevalence and severity of periodontitis based on different diagnostic methods in a historical Austrian population from the early middle ages. BACKGROUND: The description of the oral health status of archaeological material can provide interesting insights into prevalence, severity, and extent of oral diseases. Herein, the periodontal health status of the skeletal remains of medieval Avars (700-800 AD), which were considered as one of the earliest Avarian settlements in Austria, was investigated. METHODS: The skeletal remains of 128 Avars were examined; age and gender were estimated by standard forensic methods and tooth loss and root caries were recorded. Periodontitis was assessed by (a) measurement of the alveolar bone levels (ABL) and (b) evaluation of the interdental septa. RESULTS: A mean ABL of 4.8 mm was determined, root caries tended to accumulate in teeth with a higher alveolar bone loss, and on average, 6.2 teeth were lost antemortem. Independent of the diagnostic method >90% of the subjects were judged as periodontally diseased, and age and tooth type were significant predictors. However, on the tooth level the presence of periodontitis varied considerably depending on the diagnostic method; that is, 7.6% versus 47.2% of the teeth were judged as healthy based on ABL or interdental septa, respectively. CONCLUSION: The periodontal status of the skeletal remains of medieval Avars revealed a considerable high prevalence of periodontitis (ie, >90% of this population displayed periodontal tissue breakdown). However, the diagnostic method, disease definition, and data presentation should be considered when comparing results of archaeological material.

Oral health status in historic population: Macroscopic and metagenomic evidence.

Recent developments in High-Throughput DNA sequencing (HTS) technologies and ancient DNA (aDNA) research have opened access to the characterization of the microbial communities within past populations. Most studies have, however, relied on the analysis of dental calculus as one particular material type particularly prone to the molecular preservation of ancient microbial biofilms and potential of entire teeth for microbial characterization, both of healthy communities and pathogens in ancient individuals, remains overlooked. In this study, we used shotgun sequencing to characterize the bacterial composition from historical subjects showing macroscopic evidence of oral pathologies. We first carried out a macroscopic analysis aimed at identifying carious or periodontal diseases in subjects belonging to a French rural population of the 18th century AD. We next examined radiographically six subjects showing specific, characteristic dental pathologies and applied HTS shotgun sequencing to characterize the microbial communities present in and on the dental material. The presence of Streptococcus mutans and also Rothia dentocariosa, Actinomyces viscosus, Porphyromonas gingivalis, Tannerella forsythia, Pseudoramibacter alactolyticus, Olsenella uli and Parvimonas micra was confirmed through the presence of typical signatures of post-mortem DNA damage at an average depth-of-coverage ranging from 0.5 to 7X, with a minimum of 35% (from 35 to 93%) of the positions in the genome covered at least once. Each sampled tooth showed a specific bacterial signature associated with carious or periodontal pathologies. This work demonstrates that from a healthy independent tooth, without visible macroscopic pathology, we can identify a signature of specific pathogens and deduce the oral health status of an individual.

Arthritis and Periodontitis: An Association Debated for Over Two Centuries.

The chronic diseases, rheumatoid arthritis (RA) and periodontal disease (PD) lead to confined destruction of soft and hard tissues as a result of inflammatory processes. Their pathogenesis is dictated by a network of inflammatory cells and its mediators. They also share some etiological risk factors and therapeutic alternatives. The evolution of focal infection theory is summarized in this review, with special reference to PD and its relationship to RA. Foci of chronic infections exist in the oral cavity and may result in anatomically distant disease in certain individuals. Recent cumulative evidences document the influence of inflammatory diseases such as RA on the development of PD. Historical evidences and new theories on the interrelationship between the two diseases have the potential to identify novel mechanisms and therapy to improve patient outcomes. This review focuses on not only the association of focal infection theory and RA, but also on the reciprocal effects of RA and PD.

Gengivas saudáveis retardam a progressão de aterosclerose nas carótidas / Healthy gums slow the progression of carotid atherosclerosis

Estudos têm associado a doença periodontal com a aterosclerose e as doenças cardiovasculares. Este trabalho apresenta resultados de importante estudo que evidencia essa relação. Esta é a primeira evidência que comprova que a melhora no periodonto, definido pelos aspectos clínicos e microbiológicos, está associada a menor progressão de aterosclerose das carótidas. O trabalho, uma coorte de base populacional,ressalta a importância de uma abordagem multidisciplinar para os pacientes, especialmente dos médicos e cirurgiões-dentistas, para a prevenção e controle das doenças cardiovasculares. Futuros estudos poderão mostrar que a saúde bucal pode ser um importante indicador prognóstico da saúde geral do paciente.

Studies have linked periodontal disease to atherosclerosis and cardiovascular diseases. This paper presents the results of a major study that underscores this relationship. This is the first evidence showing that better periodontal conditions, defined through clinical and microbiological aspects, are associated with less progression incarotid atherosclerosis. This population-based cohort study highlights the importance of a multidisciplinary approach to patients, especially for physicians and dentists, in order to prevent and control cardiovascular diseases. Future studies might well show that oral health could be an important prognostic indicator of general patient health.

Oral microbiota and systemic disease.

It is well known that bacteria are the primary cause of infectious diseases, however, evidence is emerging that these organisms are also indirectly responsible for several diseases including cancer and rheumatoid arthritis. The oral cavity is home to several million bacteria that can cause two major diseases-periodontitis and caries. The relationship between periodontopathic bacteria and systemic diseases has been explored for several years. The concept of the oral cavity as a source of distant infection has been debated for at least a century. This review will discuss the historic aspects of the development of the focal infection theory, the reasons for its demise, its re-emergence and current status.

Periodontal disease epidemiology - learned and unlearned?

The notion of periodontal disease being the major cause of tooth loss among adults was rooted in the focal infection paradigm that dominated the first half of the 20th century. This paradigm was established largely by personal opinions, and it was not until the development of periodontal indices in the mid-1950s that periodontal epidemiology gained momentum. Unfortunately, the indices used suffered from a number of flaws, whereby the interpretation of the research results took the form of circular reasoning. It was under this paradigm that therapeutic and preventive intervention for periodontal diseases became entirely devoted to oral hygiene, as poor oral hygiene and older age were understood to explain nearly all the variation in disease occurrence. In the early 1980s, studies appeared that contradicted the concepts of poor oral hygiene as the inevitable trigger of periodontitis and of linear and ubiquitous periodontitis progression, whereby periodontal epidemiology was led into a relatively short-lived high-risk era. At this time, it became evident that old scourges continue to haunt periodontology: the inability to agree in operational clinical criteria for a periodontitis diagnosis and the inability to devise both a meaningful and a useful classification of periodontal diseases based on nominalist principles. The meager outcome of the high-risk era led researchers to resurrect the focal infection paradigm, which is now dressed up as periodontal medicine. Unfortunately, these developments have left the core of periodontology somewhat disheveled and deserted.

Oral health and the postcontact adaptive transition: A contextual reconstruction of diet in Mórrope, Peru.

This work explores the effects of European contact on Andean foodways in the Lambayeque Valley Complex, north coast Peru. We test the hypothesis that Spanish colonization negatively impacted indigenous diet. Diachronic relationships of oral health were examined from the dentitions of 203 late-pre-Hispanic and 175 colonial-period Mochica individuals from Mórrope, Lambayeque, to include observations of dental caries, antemortem tooth loss, alveolar inflammation, dental calculus, periodontitis, and dental wear. G-tests and odds ratio analyses across six age classes indicate a range of statistically significant postcontact increases in dental caries, antemortem tooth loss, and dental calculus prevalence. These findings are associated with ethnohistoric contexts that point to colonial-era economic reorganization which restricted access to multiple traditional food sources. We infer that oral health changes reflect creative Mochica cultural adjustments to dietary shortfalls through the consumption of a greater proportion of dietary carbohydrates. Simultaneously, independent skeletal indicators of biological stress suggest that these adjustments bore a cost in increased nutritional stress. Oral health appears to have been systematically worse among colonial women. We rule out an underlying biological cause (female fertility variation) and suggest that the establishment of European gender ideologies and divisions of labor possibly exposed colonial Mochica women to a more cariogenic diet. Overall, dietary change in Mórrope appears shaped by local responses to a convergence of colonial Spanish economic agendas, landscape transformation, and social changes during the postcontact transition in northern Peru. These findings also further the understandings of dietary and biocultural histories of the Western Hemisphere.

El papel de la genética en la aparición y desarrollo de la periodontitis. II: polimorfismos asociados a la enfermedad periodontal / The role of genetics in the development and progression of periodontits. II: polymorphism associated to periodontal disease

La periodontitis es una enfermedad multifactorial que resulta de la interacción de bacterias periodonto patógenas con los mecanismos de respuesta inmune del huésped y que se caracterizador una reacción inflamatoria que afecta al aparato de inserción del diente. Las enfermedades multifactoriales habitualmente envuelven complejas interacciones de muchos genes y factores ambientales. El tipo de variaciones genéticas involucradas en este tipo de enfermedades se denominan polimorfismos genéticos, son varios y normalmente sus efectos fenotípicos son limitados. En la primera parte de esta revisión analizamos la evidencia científica de la asociación entre periodontitis y genética. En esta segunda parte revisaremos esta asociación fundamentalmente desde las investigaciones sobre los polimorfismos con una proyección más relevante en su relación con la periodontitis (AU)

Periodontitis is a multifactorial disease in which the interaction of periodontal pathogens with the host immune defence mechanism characterizes an inflamatory reaction that affects the attachment apparatus of the tooth. Multifactorial diseases normally involve complex genetic-enviromental interactions. The type of genetic variations described in these diseases are defined as polymorphisms. Different polymorphysm have been observed and normally the phenotypic consequences are limited. In the first part of this review the evidence of association between Periodontitis and Genetics is analyzed. In the second part a special focus will be dedicated to research on polymorphysm and the clinical projection related to Periodontitis (AU)

La enfermedad periodontal en diversas poblaciones del México prehispánico / Periodontal disease in various populations from prehispanic Mexico

Los estudios en poblaciones desaparecidas son útiles para conocer el estado de salud de grupos de individuos que nos antecedieron, en este caso consideramos analizar el estado de salud periodontal. En este trabajo hemos utilizado un método propuesto anteriormente, de tal manera que es posible hacer comparaciones entre distintas poblaciones. La selección de las muestras contempló a cuatro poblaciones del México prehispánico, distantes geográficamente, pero cercanas cronológicamente, estas colecciones son las de Jaina, Tlatelolco, Pericues y Cholula, almacenadas en la Dirección de Antropología Física del INAH. Los resultados del estudio muestran que la enfermedad periodontal estuvo presente en grado leve, en la mayor parte de los individuos estudiados en las cuatro poblaciones, y sólo algunos individuos la presentaron en forma moderada. Se analizan algunos factores que pudieron influir en la presencia y severidad de la enfermedad periodontal en el México prehispánico.

From alveolar diffuse atrophy to aggressive periodontitis: a brief history.

Technologic advances in mechanics, electronics, physics, chemistry, and computer science have contributed to advances in dental medicine. Periodontology is not only a clinical science but is also directly related to the basic sciences. Research is conducted in laboratories rather than in clinics now. During the last century, aggressive periodontitis has received attention from numerous researchers because of its multifactorial features. This paper explores the long scientific journey of aggressive periodontitis, beginning with its first definition as alveolar diffuse atrophy. Perhaps in the future, "alveolar diffuse atrophy" will be referred to by another name or term. However, this journey will never end.

Pasado, presente y futuro de la microbiología de la periodontitis / Past, present and future of the microbiology of periodontitis

Es bien sabido que la periodontitis es una enfermedad de origen infeccioso, pero posee características propias que hacen difícil su conocimiento etiopatogénico, y en consecuencia, su tratamiento. Numerosos avances relacionados con el estudio microbiológico de la placa bacteriana se están llevando a cabo en los últimos años, con el objetivo de optimizar los recursos terapéuticos y ofrecer a los pacientes una atención clínica predecible basada en la evidencia científica. El objetivo de este artículo es el de revisar la literatura actual y hacer énfasis en los nuevos conceptos microbiológicos que determinarán el futuro de las investigaciones acerca del diagnóstico y tratamiento de la periodontitis (AU)

It is well known in our days that periodontitis can be considered as an infectious disease with certain features in common with other diseases, but with some other features that make it different and unique, what makes it difficult to reach a good knowledge of its etiopathogenesis and, in consequence, of its treatment. Many advances in relation to the composition of the dental plaque have been done in the last years, with the aim of improving the treatments and being able to offer our patients a good clinical attention based on scientific evidence. The aim of this article is to review the literature and make emphasis on the new microbiological concepts which will give place to the future investigations about the diagnose and treatment of the periodontitis (AU)

Coca chewing in prehistoric coastal Peru: dental evidence.

In this study, we describe the dental health of four prehistoric human populations from the southern coast of Peru, an area in which independent archaeological evidence suggests that the practice of coca-leaf chewing was relatively common. A repeated pattern of cervical-root caries accompanying root exposure was found on the buccal surfaces of the posterior dentition, coinciding with the typical placement of coca quids during mastication. To further examine the association between caries patterning and coca chewing, caries site characteristics of molar teeth were utilized as indicators for estimating the likelihood of coca chewing for adults within each of the study samples. Likelihood estimates were then compared with results of a test for coca use derived from hair samples from the same individuals. The hair and dental studies exhibited an 85.7% agreement. Thus, we have demonstrated the validity of a hard-tissue technique for identifying the presence of habitual coca-leaf chewing in ancient human remains, which is useful in archaeological contexts where hair is not preserved. These data can be used to explore the distribution of coca chewing in prehistoric times. Simultaneously, we document the dental health associated with this traditional Andean cultural practice.