The Archaea domain: Exploring historical and contemporary perspectives with in silico primer coverage analysis for future research in Dentistry.

OBJECTIVE: The complete picture of how the human microbiome interacts with its host is still largely unknown, particularly concerning microorganisms beyond bacteria. Although existing in very low abundance and not directly linked to causing diseases, archaea have been detected in various sites of the human body, including the gastrointestinal tract, oral cavity, skin, eyes, respiratory and urinary systems. But what exactly are these microorganisms? In the early 1990 s, archaea were classified as a distinct domain of life, sharing a more recent common ancestor with eukaryotes than with bacteria. While archaea's presence and potential significance in Dentistry remain under-recognized, there are concerns that they may contribute to oral dysbiosis. However, detecting archaea in oral samples presents challenges, including difficulties in culturing, the selection of DNA extraction methods, primer design, bioinformatic analysis, and databases. DESIGN: This is a comprehensive review on the oral archaeome, presenting an in-depth in silico analysis of various primers commonly used for detecting archaea in human body sites. RESULTS: Among several primer pairs used for detecting archaea in human samples across the literature, only one specifically designed for detecting methanogenic archaea in stool samples, exhibited exceptional coverage levels for the domain and various archaea phyla. CONCLUSIONS: Our in silico analysis underscores the need for designing new primers targeting not only methanogenic archaea but also nanoarchaeal and thaumarchaeota groups to gain a comprehensive understanding of the archaeal oral community. By doing so, researchers can pave the way for further advancements in the field of oral archaeome research.

Presence of host and bacterial-derived collagenolytic proteases in carious dentin: a systematic review of ex vivo studies.

Introduction and aim: The presence of host collagenases in the degradation of the protein matrix at later stages of carious dentin lesions development, as well as the potential involvement of bacterial collagenases, have been suggested but lack conclusive evidence. This study aims to conduct a systematic review to comprehensively assess the profile of host and bacterial-derived collagenolytic proteases in both root and coronal dentin carious lesions. Methods: The search was performed in eight databases and the grey literature. Studies evaluating ex vivo dentin, extracted teeth, or biofilms from natural caries lesions were included. The methodological quality of studies was assessed using the Joanna Briggs Institute tool. Synthesis of the results and the certainty of evidence were performed following the Synthesis without Meta-analysis (SWiM) checklist and GRADE approach for narrative synthesis, respectively. Results: From 935 recovered articles, 18 were included. Although the evidence was very uncertain, it was possible to suggest that 1) MMP-2, MMP-9, MMP-13, and CT-B may be increased in carious dentin when compared to sound dentin; 2) there is no difference in MMP-2 presence, while MMP-13 may be increased in root when compared to coronal carious dentin; 3) there is no difference of MMP-2 and MMP-9 expression/activity before and after cavity sealing; 4) MMP-8 may be increased in the dentin before cavity sealing compared to dentin after cavity sealing; 5) there is no difference of MMP-20 in irradiated vs. non-irradiated carious dentin. MMP-20 probably reduces in carious outer dentin when compared to carious inner dentin (moderate certainty). Genes encoding bacterial collagenolytic proteases and protein-degrading bacteria were detected in coronal and root carious lesions. Conclusion: Trends in the direction of the effect were observed for some collagenolytic proteases in carious dentin, which may represent a potential target for the development of new treatments. (Protocol register-PROSPERO: CRD42020213141).

Unraveling the Endodontic Archaeome: A Systematic Review with Meta-Analysis.

INTRODUCTION: The controversial issue of whether the Archaea domain plays a role in endodontic infections is the focus of this systematic review with meta-analysis. The aim is to emphasize the significance of minority microbial domains in oral dysbiosis by evaluating the prevalence of archaea in root canals and its association with clinical parameters such as symptomatology and type of endodontic infection. METHODS: The search strategy involved researching 6 databases and the gray literature. Publications were accepted in any year or language that identified archaea in samples from endodontic canals. A 2-step selection process narrowed the final choice to 16 articles. The methodological quality of the studies was evaluated using tools from the Joanna Briggs Institute, and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS: The results showed that archaea were present in 20% (95% [confidence interval] CI = 8%-32%) of individuals with endodontic samples analyzed. The samples were about twice as likely to be archaeal-positive if collected from individuals with primary vs. persistent/secondary infection (odds ratio = 2.33; 95% CI = 1.31-4.14; I2 = 0%), or individuals with self-reported vs. symptom-free infections (odds ratio = 2.67; 95% CI = 1.47-4.85; I2 = 0%). Methanogenic archaea were reported in 66% of the included studies. Representative members of phyla Thaumarchaeota and Crenarchaeota were also identified. CONCLUSIONS: Archaea are present in about one-fifth of the infected root canals. Recognized biases in experimental approaches for researching archaea must be addressed to understand the prevalence and roles of archaea in endodontic infections, and to determine whether the decontamination process should include the elimination or neutralization of archaea from root canals (International Prospective Register of Systematic Reviews protocol = CRD42021264308).

Enrichment of Acid-Associated Microbiota in the Saliva of Type 2 Diabetes Mellitus Adults: A Systematic Review.

It could conceivably be hypothesized that a link exists between an altered microbiota due to local hyperglycemia and the increased risk of caries in diabetes mellitus (DM). This systematic review aimed to perform a cross-study comparison into the salivary microbiota of adults with type 2 diabetes mellitus (T2D) compared to adults without T2D, particularly focusing on the abundance of acid-associated bacteria. This report follows PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Studies using next-generation sequencing and other molecular techniques are included. The methodological quality of individual studies was assessed using appropriate Joanna Briggs Institute tools. The certainty of the evidence considering the effect direction was evaluated using the GRADE approach. From 2060 titles retrieved, 12 were included in the data synthesis, totalling 873 individuals with T2D and controls evaluated across the literature. Weighted averages of blood glucose levels (HbA1c-fasting blood glucose) were 8.21%-172.14 mg/dL and 5.12%-84.53 mg/dL for T2D and controls, respectively. In most studies, the relative abundance of acidogenic and aciduric bacteria was higher in diabetics when compared to their normoglycaemic controls. Whilst the evidence certainty was very low, there was a consistent Proteobacteria depletion and Firmicutes enrichment in T2D. As for the acid-associated genera, there was consistent enrichment of Lactobacillus and Veillonela for T2D. Tannerella/T. forsythia was enriched in T2D saliva, but the certainty is low. Further well-designed cohorts are needed to clarify the distribution of acid-associated microorganisms in the saliva of adults with T2D and how this can be clinically manifested (PROSPERO = CRD42021264350).

Dental education profile in COVID-19 pandemic: A scoping review.

INTRODUCTION: This scoping review aimed to determine the frequency of different teaching methodologies, tools and platforms applied in dental education during the COVID-19 pandemic. MATERIALS AND METHODS: The search strategy was performed in six databases and grey literature. A total of 28 questionnaire-based studies were included, without language or time restriction, from 20 different countries. RESULTS: Six thousand five hundred sixty-five participants were assessed: 84% undergraduates, 9% of faculty members, 5% of postgraduate students/residents/trainees and 2% of dental schools/residency programs. The pooled eligible data for teaching methodologies were 62% of a combination of different methods (95% CI, 35.5% to 82.3%), 23% a combination of synchronous and asynchronous formats (95% CI, 8.2% to 50.2%) and 15% for only synchronous lectures (95% CI, 4.3% to 42.2%). The reported tools were laptops (40%), smartphones (40%), tablets (40%), desktops (20%), Blackboard (20%), Respondus Lockdown Browser (20%), eProctor (20%) and PowerPoint (20%). The most used platforms were Zoom (70.6%), Microsoft Teams (23.5%) and Cisco Webex (23.5%). A better time management (17.9%; 95% CI, 7.9% to 35.6%) and the possibility of revision with additional notes (14.3%; 95% CI, 5.7% to 31.5%) was the greatest advantages related to dental e-learning, while the increased levels of anxiety/stress/burnout/exhaustion (35.7%; 95% CI, 21% to 54.2%) and internet connection problems (35.7%; 95% CI, 21% to 54.2%) was the most cited disadvantages. CONCLUSION: This scoping review showed promising blended teaching methodologies, tools and platforms in the dental education profile. The evidence suggests that e-learning technologies can widely contribute to dental education during the COVID-19 pandemic. Therefore, this study makes a major contribution to research by assessing the impact of COVID restrictions on dental education and further studies are needed to identify how restrictions in dental practice will affect future professionals.

Meta-analyses on the Periodontal Archaeome.

Recently, we have published a scoping review on the oral archaeome, showing that these microorganisms inhabit various oral niches, including periodontal sites. In order to reinforce the importance of the Archaea domain and alert the scientific community about the importance of inter-domain relationships in oral dysbiosis, we have performed meta-analyses evaluating the prevalence of archaea in periodontal diseases (PROSPERO protocol: CRD42020213109). A systematic search in the literature was conducted in several databases and in grey literature, retrieving 30 reports on periodontal archaeome, published from 1980 to 2020. The methodological quality of included studies and the certainty of evidence were evaluated by using validated tools. Most studies focused on the detection of methanogens, revealing that the diversity of the periodontal archaeome is currently underestimated. Two meta-analyses concluded that individuals with periodontitis are prone to have archaeal-positive subgingival biofilms when compared to periodontally healthy individuals (OR 6.68, 95% CI 4.74-9.41 for 16S rRNA gene analysis and OR 9.42, 95% CI 2.54-34.91 for mcrA gene analysis). Despite the archaeal enrichment in sites with periodontitis, less than half of the individuals with periodontitis tested positive for archaeal DNA (general estimative of 46%; 95% CI 36-56%). Conventional treatment for periodontitis reduced the archaeal population, but systemic antibiotics used as adjunctive therapy did not increase its effectiveness. Hence, it could conceivably be hypothesised that archaea are secondary colonizers of areas with dysbiosis, probably flourishing in the inflammatory environment. Due to their lower prevalence, archaeal cells are probably underestimated by the current detection protocols. It may also be speculated that archaea do not have a single central role in the infection, with bacterial cells directly involved in that role. New studies are necessary, with different methodological approaches, to explore the underestimated diversity of the oral archaeome.

Low-Abundant Microorganisms: The Human Microbiome's Dark Matter, a Scoping Review.

Research on the human microbiome has mainly been restricted to the identification of most abundant microbiota associated with health or disease. Their abundance may reflect their capacity to exploit their niche, however, metabolic functions exerted by low-abundant microrganisms can impact the dysbiotic signature of local microbial habitats. This scoping review aims to map the literature regarding the management of low-abundant microorganisms in studies investigating human microbiome samples. A systematic literature search was performed in 5 electronic databases, as well as grey literature. We selected clinical microbiome studies targeting human participants of any age, from any body site. We also included studies with secondary data which originated from human biofilm samples. All of the papers used next-generation sequencing (NGS) techniques in their methodology. A total of 826 manuscripts were retrieved, of which 42 were included in this review and 22 reported low-abundant bacteria (LB) in samples taken from 7 body sites (breast, gut, oral cavity, skin, stomach, upper respiratory tract (URT), and vagina). Four studies reported microbes at abundance levels between 5 and 20%, 8 studies reported between 1 and 5%, and 18 studies reported below 1%. Fifteen papers mentioned fungi and/or archaea, and from those only 4 (fungi) and 2 (archaea) produced data regarding the abundance of these domains. While most studies were directed towards describing the taxonomy, diversity and abundance of the highly abundant species, low-abundant species have largely been overlooked. Indeed, most studies select a cut-off value at <1% for low-abundant organisms to be excluded in their analyses. This practice may compromise the true diversity and influence of all members of the human microbiota. Despite their low abundance and signature in biofilms, they may generate important markers contributing to dysbiosis, in a sort of 'butterfly effect'. A detailed snapshot of the physiological, biological mechanisms at play, including virulence determinants in the context of a dysbiotic community, may help better understand the health-disease transition.