Periodontal pocket and COVID-19: Could there be a possible link?

COVID-19 is the emerging health emergency ruining the well being of individuals and devastating the global economies. Sustained research focusing on the virus has been on throughout the world. However, no definitive remedies have yet been derived in the containment of the virus. Steady knowledge on the pathogenesis of the virus has revealed certain consistent features specific to the disease which includes massive destruction of the lung due to the presence of excessive angiotensin-converting enzyme receptors (ACE2) which are essential for the viral entry inside the host. Once, access is gained multiplication occurs resulting in suppressing the immune response of the body against the virus. Henceforth, the equilibrium of the host is disrupted leading to manifestation of the disease. The Periodontal pocket also presents with pathology very much similar to COVID-19 and a possibility of dual role can be thought of pertaining to aspects of Periodontal Medicine.

Oral human cytomegalovirus prevalence and its relationships with periodontitis and Porphyromonas gingivalis in Japanese adults: a cross-sectional study.

OBJECTIVE: This study aimed to clarify the association between oral human cytomegalovirus (HCMV) and periodontitis in Japanese adults. METHODOLOGY: In total, 190 patients (75 men and 115 women; mean age, 70.2 years) who visited Hiroshima University Hospital between March 2018 and May 2020 were included. Oral rinse samples were taken to examine the presence of HCMV DNA using real-time polymerase chain reaction (PCR). P. gingivalis was detected by semi-quantitative PCR analysis. RESULTS: HCMV DNA was present in nine of 190 patients (4.7%). There were significant associations between HCMV presence and the presence of ≥4-mm-deep periodontal pockets with bleeding on probing (BOP) (P<0.01) and ≥6-mm-deep periodontal pockets with BOP (P=0.01). However, no significant relationship was observed between HCMV presence and periodontal epithelial surface area scores. Logistic regression analysis revealed that the presence of ≥4-mm-deep periodontal pockets with BOP was significantly associated with HCMV (odds ratio, 14.4; P=0.01). Propensity score matching was performed between patients presenting ≥4-mm-deep periodontal pockets with BOP (i.e., active periodontitis) and patients without ≥4-mm-deep periodontal pockets with BOP; 62 matched pairs were generated. Patients who had ≥4-mm-deep periodontal pockets with BOP showed a higher rate of HCMV presence (9.7%) than those who lacked ≥4-mm-deep periodontal pockets with BOP (0.0%). There was a significant relationship between HCMV presence and ≥4-mm-deep periodontal pockets with BOP (P=0.03). A significant relationship was found between HCMV/P. gingivalis DNA presence and ≥4-mm-deep periodontal pockets with BOP (P=0.03). CONCLUSIONS: Coinfection of oral HCMV and P. gingivalis was significantly associated with active periodontitis. Moreover, interactions between oral HCMV and P. gingivalis may be related to the severity of periodontal disease.

Periodontal pockets: A potential reservoir for SARS-CoV-2?

Periodontal pockets are the major clinical manifestation of Periodontitis, a chronic inflammatory oral disease affecting the teeth-supporting tissues and has high prevalence in the adult population. Periodontal pockets are ideal environments for subgingival bacterial biofilms, that interact with the supragingival oral cavity, mucosal tissues of the pocket and a peripheral circulatory system. Periodontal pockets have been found to harbor viral species such as the Herpes simplex viruses' family. Recently, the SARS-CoV-2 has gained major interest of the scientific/medical community as it caused a global pandemic (Covid-19) and paralyzed the globe with high figures of infected people worldwide. This virus behavior is still partially understood, and by analyzing some of its features we hypothesized that periodontal pocket could be a favorable anatomical niche for the virus and thus acting as a reservoir for SARS-CoV-2.

How Does Epstein-Barr Virus Contribute to Chronic Periodontitis?

Chronic periodontitis is spreading worldwide and mutually interacts with systemic diseases like diabetes mellitus. Although periodontopathic bacteria are inevitable pathogens in their onset and progression, many cases are not ascribable to the virulence of these bacteria because the effect of plaque control is limited. In contrast, Epstein-Barr virus (EBV) in the periodontium has been correlated with chronic periodontitis and has recently been considered as a promising pathogenic candidate for this disease. However, several important questions have yet to be addressed. For instance, although EBV latently infects more than 90% of individuals over the world, why do patients with chronic periodontitis exclusively harbor progeny EBV in the oral cavity? In addition, how does latently infected or reactivated EBV in the periodontium relate to the onset or progression of chronic periodontitis? Finally, is periodontitis incurable because EBV is the pathogen for chronic periodontitis? In this review, we attempt to answer these questions by reporting the current understanding of molecular relations and mechanisms between periodontopathic bacteria and EBV reactivation in the context of how this relationship may pertain to the etiology of chronic periodontitis.

Epstein-Barr virus-infected plasma cells in periodontitis lesions.

Growing evidence supports that the Epstein-Barr virus (EBV) is a putative periodontal pathogen, but little is known regarding EBV behavior in periodontitis. Here, EBV infection was monitored in saliva and periodontal pocket (PP), at baseline and 3 months after periodontal non-surgical therapy (p-NST) in 20 patients diagnosed with periodontitis. After the treatment, the patients with the improved periodontal condition (good responders) showed a significant decrease in salivary EBV load. In contrast, in poor responders, EBV load was slightly increased. Moreover, after the therapy, most patients showed clear signs of EBV infection in a deep PP (≥5 mm) selected as a study site. To investigate how EBV can persist in a PP, we further investigate cellular sites of viral replication in PP. We identified large amounts of infiltrated EBV-infected cells, mostly overlapping with CD138+ plasma cells (PC). EBV-infected PCs formed high-density clusters within the infiltrate and along the periodontal epithelium which were commonly associated with CD3+ T-cells and CD20+ B-cells to evoke diffuse ectopic lymphoid-like structures. Taking together, this study provides new insights to support a model where the periodontal condition may play a major role in oral EBV shedding. Since PC harbors the late productive phases of EBV replication, the periodontal condition may favor B-cell differentiation with possible amplification of periodontal EBV infection and viral spreading. PCs have long been recognized as pathogenic markers in inflammatory lesions. Our finding sheds new light on the role of EBV infection and PC in periodontitis.

Oral human cytomegalovirus prevalence and its relationships with periodontitis and Porphyromonas gingivalis in Japanese adults: a cross-sectional study

Abstract Objective This study aimed to clarify the association between oral human cytomegalovirus (HCMV) and periodontitis in Japanese adults. Methodology In total, 190 patients (75 men and 115 women; mean age, 70.2 years) who visited Hiroshima University Hospital between March 2018 and May 2020 were included. Oral rinse samples were taken to examine the presence of HCMV DNA using real-time polymerase chain reaction (PCR). P. gingivalis was detected by semi-quantitative PCR analysis. Results HCMV DNA was present in nine of 190 patients (4.7%). There were significant associations between HCMV presence and the presence of ≥4-mm-deep periodontal pockets with bleeding on probing (BOP) (P<0.01) and ≥6-mm-deep periodontal pockets with BOP (P=0.01). However, no significant relationship was observed between HCMV presence and periodontal epithelial surface area scores. Logistic regression analysis revealed that the presence of ≥4-mm-deep periodontal pockets with BOP was significantly associated with HCMV (odds ratio, 14.4; P=0.01). Propensity score matching was performed between patients presenting ≥4-mm-deep periodontal pockets with BOP (i.e., active periodontitis) and patients without ≥4-mm-deep periodontal pockets with BOP; 62 matched pairs were generated. Patients who had ≥4-mm-deep periodontal pockets with BOP showed a higher rate of HCMV presence (9.7%) than those who lacked ≥4-mm-deep periodontal pockets with BOP (0.0%). There was a significant relationship between HCMV presence and ≥4-mm-deep periodontal pockets with BOP (P=0.03). A significant relationship was found between HCMV/P. gingivalis DNA presence and ≥4-mm-deep periodontal pockets with BOP (P=0.03). Conclusions Coinfection of oral HCMV and P. gingivalis was significantly associated with active periodontitis. Moreover, interactions between oral HCMV and P. gingivalis may be related to the severity of periodontal disease.

A novel phage from periodontal pockets associated with chronic periodontitis.

Bacteriophages often constitute the majority of periodontal viral communities, but phages that infect oral bacteria remain uncharacterized. Here, we present the genetic analysis of the genome of a novel siphovirus, named Siphoviridae_29632, which was isolated from a patient with periodontitis using a viral metagenomics-based approach. Among 43 predicted open reading frames (ORFs) in the genome, the viral genes encoding structural proteins were distinct from the counterparts of other viruses, although a distant homology is shared among viral morphogenesis proteins. A total of 28 predicted coding sequences had significant homology to other known phage ORF sequences. In addition, the prevalence of Siphoviridae_29632 in a cohort of patients with chronic periodontitis was 41.67%, which was significantly higher than that in the healthy group (4.55%, P < 0.001), suggesting that this virus as well as its hosts may contribute to the ecological environment favored for chronic periodontitis.

Efficacy of the ND:YAG laser therapy on EBV and HSV1 contamination in periodontal pockets.

AIM: The aim of this retrospective multicenter study was to verify the efficacy of Nd:YAG laser in the treatment of periodontal pockets infected by Epstein-Barr Virus (EBV) and Herpes Simplex Virus 1 (HSV1). METHODS: Subgingival plaque samples of 291 Italian periodontal patients were analyzed by Real Time PCR to evaluate the frequency of both viruses before and after Nd:YAG laser-assisted periodontal treatment. RESULTS: Before treatment, EBV and HSV1 were observed in 29.9% and in 3.8% of periodontal patients respectively, while co-infection with both viruses was detected in 1.7% of cases. Periodontal Nd:YAG laser treatment ("Periodontal Biological Laser-Assisted Therapy", PERIOBLAST) produced statistical significant benefits, especially in EBV periodontal infection: 78.2% of EBV positive patients became EBV-negative following treatment. CONCLUSIONS: Results of this preliminary study highlight that EBV is found in periodontal pockets more frequently than HSV1, supporting the theory of the potential role of EBV in the onset and progression of periodontal disease. Moreover, our data showed that Nd:YAG laser-assisted periodontal treatment (Perioblast) is also effective in case of viral infection, validating evidences that it represents a successful alternative approach to traditional periodontal protocols.

Human papilloma virus in oral mucosa and its association with periodontal status of gynecologically infected women.

The aim of this study was to determine whether Human Papillomavirus was present in tongue and periodontium of periodontally healthy and diseased women who had genital lesions caused by the virus. Thirty non-menopausal women, systemically healthy and diagnosed with gynecological HPV lesions, were referred by the Gynecology Service Department of the University Maternal Neonatal Hospital of the City of Cordoba. Anamnesis, oral mucosa examination and periodontal clinical assessment were performed. Three brush samples were taken per patient: two from the same periodontal location (external epithelium of the gum and internal epithelium of the periodontal sulcus/pocket), and the third from the tongue. The 90 samples were submitted to Pap cytology and Polymerase Chain Reaction. The data were statistically analyzed by "Chi Square Test" (χ2) and "Kappa Index" (κ). High prevalence of HPV was found in the tongue (30%) and periodontal tissues (15%). High risk (HR) genotype -16 was detected with the highest percentage (67%), and genotypes -52 and -6 were also detected. Whenever HPV was present in periodontal location, it was also identified in the tongue of the same patients, of whom 88.89% reported that they practiced oral sex. Is worth noting the clinical finding of stomatologic lesions compatible with foliate papillitis in patients with positive intraoral HPV. High prevalence of HPV was found in the female population in Cordoba, with genotype -16 being detected at the highest percentage. No positive correlation was found between HPV and higher incidence and severity of periodontal lesions.

Levels of HIV-1 in subgingival biofilm of HIV-infected patients.

AIM: The aims of the current study were to compare the levels of HIV-1 in the subgingival biofilm (SHVL) between detectable and undetectable plasmatic HIV-1 viral load (PHVL) in HIV-infected patients as well as to determine the association of SHVL with PHVL and clinical periodontal parameters. MATERIAL AND METHODS: Forty-one HIV-infected individuals were divided into two groups: detectable (21) and undetectable (20) PHVL. Subgingival biofilm samples were obtained for detection and quantification of HIV-1 by real-time RT-PCR. To estimate the effect of co-variables on the outcome undetectable SHVL, the Generalized Estimation Equation (GEE) was employed. RESULTS: Detectable SHVL was observed only in the detectable PHVL group and the detection of the HIV-1 was observed in 40% of these individuals. In the bivariate analysis between co-variables from the individual level and the outcome SHVL, significant difference was observed only for the CD4+ T lymphocytes levels (p = 0.017). The multiple logistic model demonstrated that only CD4+ T lymphocytes levels had a significant effect on the outcome undetectable SHVL [OR 8.85 (CI 3.6-9.2), p = 0.002]. CONCLUSION: HIV-1 can be detected and quantified in the subgingival biofilm of HIV-infected individuals, but these findings are not associated with PHVL and periodontal clinical parameters.

Detection of herpes simplex virus type 1 in gingival crevicular fluid of gingival sulcus/periodontal pocket using polymerase chain reaction.

INTRODUCTION: Pathogenesis and some characteristics of periodontitis cannot be fully explained by bacterial etiology alone. Herpes viruses may bridge the gap between clinical characteristics and molecular understanding of periodontal destruction. OBJECTIVE: The aim of this study was to investigate the prevalence of herpes simplex virus type 1 (HSV-1) in gingival crevicular fluid (GCF) of healthy and damaged periodontium in Serbian population and to explore potential correlation between the presence of this virus and the level of periodontal destruction. METHODS: Samples were collected from gingival sulcus/periodontal pockets by sterile paper points and the presence of viral DNA in gingival crevicular fluid was assessed by PCR. RESULTS: There was no statistically significant difference in HSV-1 in presence between periodontitis patients (PG = 38.9%) and healthy controls (HC = 32.3%), (Chi-square test, with Yates' correction p = 0.7574). However, HSV-1 positive patients showed significantly higher values of parameters of periodontal destruction (PPD = 7.11 +/- 2.52, CAL = 5.46 +/- 2.34) than periodontitis patients without HSV-1 in gingival crevicular fluid (PPD = 4.70 +/- 1.79, CAL = 3.39 +/- 2.65) (p values respectively, p = 0.002 and p = 0.023, Independent Samples T-Test). HSV-1 occurred more often in deeper (PPD > or = 6 mm) (69.2%) than in shallow pockets (3 mm < PPD < 6 mm) (18.2%) (Chi-square test, with Yates' correction, p = 0.008). Plaque index was lower in the HSV-1 positive group (0.84 +/- 0.69 vs. 1.43 +/- 0.76, p = 0.023, Independent Samples T-Test). CONCLUSION: This study demonstrated that the presence of HSV-1 in the gingival crevicular fluid coincides with a higher degree of tissue destruction in patients with periodontitis.

Higher prevalence of Epstein-Barr virus DNA in deeper periodontal pockets of chronic periodontitis in Japanese patients.

Periodontitis, a complex chronic inflammatory disease caused by subgingival infection, is among the most prevalent microbial diseases in humans. Although traditional microbiological research on periodontitis has focused on putative bacteria such as Porphyromonas gingivalis, the herpes virus is proposed to be involved in the pathogenesis of periodontitis because bacterial etiology alone does not adequately explain various clinical aspects. In this study, we established for the first time, more Epstein-Barr virus (EBV) DNA is found deeper in periodontal pockets of chronic periodontitis in Japanese patients. Subgingival samples were collected from 85 patients with chronic periodontitis having two periodontal sites with probing depths (PD) of ≤ 3 mm (shallow) or ≥ 5 mm (deep) and were subjected to a nested polymerase chain reaction. EBV DNA was more frequently detected in patients with deeper PD sites (66%) than in those with shallow PD sites (48%) or healthy controls (45%). Coexistence of EBV DNA and P. gingivalis was significantly higher in patients with deeper PD sites (40%) than in those with shallow PD sites (14%) or healthy controls (13%). Although no difference in clinical index for periodontitis, the odds ratio of EBV DNA in patients with deeper PD sites was 2.36, which was 2.07-fold higher than that in those with shallow PD sites. Interestingly, the odds of acquiring chronic periodontitis (PD ≥ 5 mm) were higher in the presence of both EBV DNA and P. gingivalis compared with either EBV DNA or P. gingivalis only. In addition, we also observed that EBV-encoded small RNA (EBER) in positive cells of human gingival tissues. These results would suggest that EBV DNA may serve as a pathogenic factor leading to chronic periodontitis among Japanese patients.

[Effect of periodontal therapy on the subgingival microbiota in preeclamptic patients]. / Efecto del tratamiento periodontal sobre la microbiota subgingival en pacientes con preeclampsia.

INTRODUCTION: Few studies have described subgingival microbiota in pregnant women with mild preeclampsia. OBJECTIVE: Clinical periodontal and subgingival microbiota changes were identified in pregnant women with mild preeclampsia after periodontal treatment. MATERIALS AND METHODS: In a secondary analysis of a randomized clinical trial, 57 preeclamptic women were studied at Hospital Universitario del Valle in Cali, Colombia. Thirty one women were randomized to the periodontal intervention group (subgingival scaling and planing ultrasonic and manual) during pregnancy and 26 to the control group (supragingival prophylaxis). Periodontal clinical parameters and subgingival microbiota were characterized at the time of acceptance into the study and again at postpartum. Eight periodontopathic bacteria and 2 herpesviruses were assessed by polymerase chain reaction. Chi-square, McNemar or Student's t tests were used, with a significance level of p≤0.05. RESULTS: Both groups were comparable in the clinical and microbiological variables at baseline. Periodontal treatment reduced the average pocket depth in the intervention group from 2.4±0.3 to 2.3±0.2 mm (p<0.001) and in control group 2.6±0.4 to 2.44±0.4 mm, (p<0.001) and bleeding index 16.4±1.5% to 7.9±0.7% in the intervention group(p<0.001) and 17.1±1.8% to 10±0.9% in the control group (p=0.002). The frequency of detection of microorganisms did not differ significantly between groups. CONCLUSION: Scaling/root planning and supragingival prophylaxis significantly reduced the probing depth and gingival bleeding index. Periodontal treatment was not more effective than prophylaxis in reducing periodontopathic organisms or herpesvirus.

Comparative analysis of presence of Cytomegalovirus (CMV) and Epsteinbarr virus -1 (EBV-1) in cases of chronic periodontitis and aggressive periodontitis with controls.

AIM: The aim of the present study was to evaluate the presence of Cytomegalovirus (CMV) and Epsteinbarr virus -1 (EBV-1)viruses in sub gingival plaque of chronic periodontitis (groupA), aggressive periodontitis patients (group B), periodontally healthy controls (group C) and to compare the clinical parameters between virus negative and positive sites in each of these groups. MATERIALS AND METHODS: Sixty subjects were included in the study and equally divided into the 3 groups (group A - 20, group B - 20, group C - 20). Sub gingival plaque samples were obtained from the 3 deepest periodontal pocket sites in case of subjects suffering from periodontitis, and from one random bleeding site per quadrant in healthy groups. Clinical parameters like plaque index (PI), gingival index (GI), pocket depth (PD) and clinical loss of attachment (CAL) were recorded. Viral Deoxyribonucleic acid (DNA) was extracted using Proteinase-K DNA Extraction method, and the presence of CMV and EBV-1 was detected by polymerase chain reaction and 2% agarose gel. RESULTS: Results of our study showed a 45% prevalence of CMV and EBV-1 in Aggressive periodontitis cases. Prevalence of CMV in chronic periodontitis and healthy subjects was 20% and 10%, respectively; while for EBV-1 it was 25% and 0%, respectively. In terms of comparison of the clinical parameters with virus presence, both CMV and EBV-1 positive sites showed a significantly higher mean pocket depth compared to virus negative sites. CONCLUSION: Our studyshowed that the prevalence of EBV1 was higher in chronic and aggressive periodontitis subjects compared to controls and the prevalence of CMV was higher in aggressive periodontitis patients. The virus positive sites showed higher pocket depth compared to virus negative sites.

Efecto del tratamiento periodontal sobre la microbiota subgingival en pacientes con preeclampsia / Effect of periodontal therapy on the subgingival microbiota in preeclamptic patients

Introducción. Pocos estudios han descrito la microbiota subgingival en mujeres embarazadas con preeclampsia leve. Objetivo. Identificar cambios periodontales y de la microbiota subgingival en mujeres embarazadas con preeclampsia, después del tratamiento periodontal. Materiales y métodos. En un análisis secundario de un ensayo clínico de asignación aleatoria, se estudiaron 57 pacientes con preeclampsia en el Hospital Universitario del Valle de Cali. Se asignaron al azar 31 al grupo de intervención periodontal (detartraje y alisado subgingival ultrasónico y manual) durante su embarazo y otras 26 al grupo control (profilaxis supragingival). Se determinaron los parámetros clínicos periodontales y la microbiota subgingival a la inclusión al estudio y en el posparto. Se evaluaron 8 bacterias periodontopáticas y 2 virus herpes por reacción en cadena de la polimerasa. Se usaron las pruebas de ji al cuadrado, test de McNemar o t de Student, con un nivel de significancia de p≤ Resultados. Los grupos fueron comparables en las variables clínicas y microbiológicas al inicio del estudio. El tratamiento periodontal redujo el promedio de la profundidad de bolsa en el grupo de intervención de 2,44±0,31 a 2,31±0,24 mm (p=0,000) y en el grupo control de 2,58±0,37 a 2,44±0,39 mm (p=0,000),y el índice de sangrado, de 16,4±1,5 a 7,9±0,7 % en el primero (p=0,000), y de 17,1±1,8 a 10±0,9 %, en el segundo (p=0,002). La frecuencia de detección de microorganismos no varió de manera significativa entre los grupos. Conclusión. El raspaje y alisado radicular, así como la profilaxis supragingival, redujeron de manera significativa la profundidad a la sonda y el índice de sangrado gingival. El tratamiento periodontal no fue más efectivo que la profilaxis para reducir los organismos periodontopáticos o los virus herpes.

Introduction. Few studies have described subgingival microbiota in pregnant women with mild preeclampsia. Objective. Clinical periodontal and subgingival microbiota changes were identified in pregnant women with mild preeclampsia after periodontal treatment. Materials and methods. In a secondary analysis of a randomized clinical trial, 57 preeclamptic women were studied at Hospital Universitario del Valle in Cali, Colombia. Thirty one women were randomized to the periodontal intervention group (subgingival scaling and planing ultrasonic and manual) during pregnancy and 26 to the control group (supragingival prophylaxis). Periodontal clinical parameters and subgingival microbiota were characterized at the time of acceptance into the study and again at postpartum. Eight periodontopathic bacteria and 2 herpesviruses were assessed by polymerase chain reaction. Chi-square, McNemar or Student´s t tests were used, with a significance level of p≤0.05. Results. Both groups were comparable in the clinical and microbiological variables at baseline. Periodontal treatment reduced the average pocket depth in the intervention group from 2.4±0.3 to 2.3±0.2 mm (p<0.001) and in control group 2.6±0.4 to 2.44±0.4 mm, (p<0.001) and bleeding index 16.4±1.5% to 7.9±0.7% in the intervention group(p<0.001) and 17.1±1.8% to 10±0.9% in the control group (p=0.002). The frequency of detection of microorganisms did not differ significantly between groups. Conclusion. Scaling/root planning and supragingival prophylaxis significantly reduced the probing depth and gingival bleeding index. Periodontal treatment was not more effective than prophylaxis in reducing periodontopathic organisms or herpesvirus.

Herpes Simplex I virus impairs regenerative outcomes of periodontal regenerative therapy in intrabony defects: a pilot study.

AIM: To evaluate the impact of herpesvirus type-1 and -2 on the clinical outcomes of periodontal regenerative procedures in isolated deep intrabony pockets, in an experimental population with no detectable periodontal pathogens. MATERIALS AND METHODS: Seventeen periodontal intraosseous defects in 17 moderate-to-advanced periodontitis patients were treated with regenerative therapy and amelogenins. Microbiological evaluation was performed at baseline (after the completion of initial therapy) and at 1 year to exclude the presence of periodontal pathogens. Herpesviruses-1 and -2 DNA were quantified in the pocket tissues associated to the intrabony defect using molecular assays. Clinical attachment level (CAL), probing pocket depth (PPD) and gingival recession (REC) were recorded at baseline and at 1 year. RESULTS: After 1 year, the 17 defects resulted in significant CAL gain, PPD reduction and REC increase. HSV-1 was detected in five patients. Herpesvirus-2 was never found. The two subpopulations positive or negative to herpesvirus-1 were homogeneous at baseline. At 1 year, the five herpesvirus-1 positive patients resulted in lower amounts of CAL-gain and PPD reduction and greater amount of REC with respect to the 12 herpesvirus-1 negative patients. CONCLUSIONS: The presence of herpesvirus-1 at baseline is associated with poor clinical outcomes following regenerative therapy.

Prevalencia de herpes virus en bolsas periodontales de pacientes asistidos en la Cátedra de Periodoncia de la FOUNNE / Prevalence of herpes virus in periodontal pockets of patients assisted at the Periodontics Department, FOUNNE

El objetivo de este trabajo fue determinar la prevalencia de herpesvirus humano en la enfermedad periodontal en pacientes concurrentes y asistidos en la Cátedra de Periodoncia de la Facultad de Odontología de laUniversidad Nacional del Nordeste y su posible mecanismo histopatológico.El procedimiento fue realizado en el ámbito de la F.O.U.N.N.E., en la Cátedra de Periodoncia lo que se refiere a su faz clínica y en el Laboratorio Central de laProvincia Corrientes la detección microbiológica mediante Nested PCR.Con una población de 30 hombres y mujeres con edades comprendidas entre 25 y 60 años que concurran como pacientes a la Cátedra de Periodoncia de la Facultad de Odontología de la U.N.N.E. La recolección de datos se hizo a través de métodos de observación,validando, como herramientas metodológicas para el área clínica, la sonda periodontal tipo Marquis e imágenes radiográficas periapicales tomadas con la técnica del paralelo del sector o sectores compatibles con diagnóstico clínico de periodontitis. Se procedió, en el sitio de mayor profundidad de bolsa, a introducir tres conos de papel absorbentes estériles para tomar el contenido, estos conos luego fueron introducidos en medios detransporte específicos y derivados inmediatamente al Laboratorio Central de la Provincia de Corrientes, parael desarrollo del método de la reacción en cadena de la polimerasa (P.C.R.) sobre las muestras tomadas a cadapaciente a fin de detectar la presencia de los virus. Resultados: Total de pacientes que constituyeron lamuestra: 30 (100 por ciento). Pacientes con herpesvirus (HVS): 5 (17 por ciento). Pacientes sin presencia viral: 25 (83 por ciento). Los sitios infectados con virus presentaron mayor destrucción de tejidos periodontales comparativamente con sitios no infectados.

Prevalence of human cytomegalovirus and Epstein-Barr virus in subgingival plaque at peri-implantitis, mucositis and healthy sites. A pilot study.

This study evaluated the prevalence of human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) in peri-implantitis and mucositis sites and the correlation between herpesvirus and clinical parameters. Fifty-six dental implants (mean time of loading, 4.27±1.6 years) were evaluated (20 peri-implantitis, 18 mucositis, 18 healthy peri-implant sites.) The clinical parameters assessed were: visible plaque index (PI), bleeding on probing (BOP), suppuration (SUP), probing depth (PD). A polymerase chain reaction assay identified HCMV and EBV in subgingival plaque samples. The percent of sites with plaque and BOP was significantly higher around mucositis and peri-implantitis compared with healthy implants (p<0.05). The mean PD around the implants was significantly higher in peri-implantitis, followed by mucositis and healthy implants (p<0.05). HCMV was detected in 13 (65%) and EBV in 9 (45%) of the 20 peri-implantitis sites. HCMV was found in 1 of the 18 (6%) healthy periodontal sites and EBV in 2 (11%). A statistically significant correlation was found between presence of HCMV and EBV subgingivally and clinical parameters of peri-implantitis and healthy sites. These results confirm the high prevalence of HCMV and EBV in subgingival plaque of peri-implantitis sites and suggest the viruses have a possible active pathogenic role in peri-implantitis.

Influence of glycemic control on Epstein-Bar and Cytomegalovirus infection in periodontal pocket of type 2 diabetic subjects.

OBJECTIVE: The aim of the present study was to evaluate the influence of glycemic control on the frequency of Epstein-Bar (EBV) and Cytomegalovirus (CMV) in periodontal pockets of type 2 diabetic subjects with chronic periodontitis. DESIGN: Forty-six subjects presenting generalized chronic periodontitis and type 2 diabetes mellitus (DM) were selected for this study. Polymerase chain reaction (PCR) was used to determine the presence of EBV and CMV in shallow [Probing Depth (PD)≤3mm], moderate (PD=4-6mm) and deep (PD>7mm) pockets. HbA1c levels ≤7%, >7 to <10%, and ≥10% defined good, moderate and poor glycemic control, respectively. RESULTS: Higher frequency of EBV was found in the shallow pockets of the subjects with poor glycemic control (p<0.05; chi-square test). Moreover, EBV-free subjects presented moderate or good glycemic control. Glycemic control did not influence the frequency of CMV in all pocket categories. CONCLUSION: Poor glycemic control in type 2 diabetic subjects can increase the occurrence of EBV in shallow periodontal pockets.

Periodontopathic bacteria and herpesviruses in chronic periodontitis.

Periodontal disease involves complex interactions of microorganisms and host defenses. This work investigated the associations between putative bacterial pathogens, herpesviruses and chronic periodontitis. Subgingival samples were collected from 40 periodontally healthy individuals and from 40 patients with chronic periodontitis with probing depths of < or =3 mm or > or =6 mm. Multiplex and nested polymerase chain reactions were used to identify bacterial pathogens and herpesviruses. Porphyromonas gingivalis, Tannerella forsythia, Epstein-Barr virus (EBV) type 1, cytomegalovirus (CMV), Aggregatibacter actinomycetemcomitans and EBV type 2 were detected in, respectively, 95, 75, 72.5, 50, 12.5 and 10% of sites with probing depths > or =6 mm. P. gingivalis, T. forsythia, EBV-1 and CMV were statistically associated with probing depths > or =6 mm. A. actinomycetemcomitans and EBV-2 showed no association with periodontitis sites, and no significant associations were found for any of the test infectious agents and probing depths < or =3 mm. Our results confirm an association between P. gingivalis, T. forsythia, EBV-1 and CMV, and chronic periodontitis. These infectious agents may play an important synergistic role in the pathogenesis of chronic periodontitis.