Ageing with HIV - a periodontal perspective.

The importance of oral microflora composition in HIV-infected patients is well recognized. However, no studies so far have dealt with age-related changes in periodontal pathogens occurrence in HIV+ individuals. The aim of the present study was to assess and compare temporal changes of bacteria frequency in younger (≤35 years) and older (≥50 years) HIV-infected and non-infected individuals. Bacterial DNA was isolated from buccal swabs of 30 younger and 30 older subjects in both HIV+ and HIV- groups. By means of PCR the following microorganisms were detected: Aggregatibacter actinomycetemcomitans, Eikenella corrodens, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola. Oral and periodontal examinations were performed in all subjects. The prevalence of microorganisms was significantly higher in HIV+ patients compared to controls, and their distribution showed a notable shift. The decreasing incidence in HIV- subjects was: Pi>Pm>Pg>Aa>Ec>Tf>Td whilst in HIV+ it was: Pi>Pm>Ec>Pg>Tf>Aa>Td. Oral manifestations of HIV infection were more frequent in older compared to younger patients. All measured values of clinical periodontal parameters were significantly higher in older compared to younger HIV+ patients. Ageing in HIV+ subjects is accompanied with a substantial increase and rearrangements of periodontal microflora, potentially aggravating oral and systemic health.

Does the Prevalence of Periodontal Pathogens Change in Elderly Edentulous Patients after Complete Denture Treatment?

PURPOSE: To determine if wearing complete dentures can cause changes in prevalence of some of the most common periodontal pathogens in elderly edentulous patients. The need for understanding the composition of oral microflora in edentulous patients has been recognized by some authors, but no studies have dealt with the changes that occur in periodontal pathogens' prevalence as a result of complete dentures. MATERIALS AND METHODS: A total of 30 edentulous elderly (average age 71) patients participated in the study. Complete dentures were fabricated for each patient, and the residual alveolar ridges were swabbed before denture insertion. After a period of 6 months swabs were taken again. Identification of P. intermedia, A. actinomycetemcomitans, P. gingivalis, T. forsythia, T. denticola, and F. nucleatum was done by the polymerase chain reaction (PCR) method and primers specific for each microorganism. RESULTS: A noticeable increase in the presence of periodontal pathogens was observed after 6 months of denture wearing; targeted bacteria were identified in 17 pre-insertion samples compared to 28 post-insertion samples. The McNemar test was used to compare the prevalence of periodontal pathogenic bacteria before and after dental treatment. p<0.05 indicated statistical significance. Three microorganisms showed a statistically significant difference between the first and second swabbing-A. actinomycetemcomitans (6.7% vs. 40.0%, p = 0.006), P. intermedia (30.0% vs. 73.3%, p = 0.004), and T. forsythia (6.7% vs. 30.0%, p = 0.004). There was also an increase in bacteria co-associations 6 months post-insertion of complete dentures. CONCLUSIONS: The results of the present study suggested that wearing complete dentures caused a considerable increase of periodontopathic bacteria prevalence in elderly patients. Better understanding of oral microflora and the impact dental treatment has on bacterial colonies is important in modern dentistry.