Search Results (237)

Background and Objectives: Cigarette smoking is a recognized risk factor for periodontal disease and subgingival dysbiosis; however, the impact of electronic cigarettes on the subgingival microbiome in young adults is still not sufficiently investigated. This study aimed to characterize and compare the carriage and bacterial load of 20 subgingival species among young adult cigarette smokers, e-cigarette users, and non-smokers, and to evaluate whether e-cigarette use is linked to a periodontopathogen-enriched profile similar to that of smoking. Materials and Methods: In this exploratory cross-sectional study, fifty young adults were divided into three groups: cigarette smokers (n = 18), e-cigarette users (n = 16), and non-smokers (n = 16). Subgingival specimens were examined using real-time Polymerase Chain Reaction (PCR) (Perio panel; ADD Laboral B.V., Malden, The Netherlands) for 20 bacterial species. Carriage was analyzed across groups utilizing Fisher’s exact test with Cramér’s V as the effect size, while bacterial load was assessed using the Kruskal–Wallis test accompanied by Dwass–Steel–Critchlow–Fligner post hoc comparisons (jamovi; significance threshold established at p < 0.05). Results: Red-complex pathogens were more prevalent and present in greater quantities in smokers and e-cigarette groups compared to non-smokers. Porphyromonas gingivalis prevalence was seen in smokers (94.4%), vapers (75.0%), and non-smokers (56.2%; p = 0.028), whereas Tannerella forsythia was found in 100% of smokers, 87.5% of vape users, and 68.8% of the non-smokers (p = 0.022). Aggregatibacter actinomycetemcomitans was not present in non-smokers but was identified in 37.5% of vapers and 16.7% of smokers (p = 0.018), whereas Eubacterium nodatum was significantly elevated in tobacco users (p = 0.012; Cramér’s V = 0.449). In contrast, Prevotella nigrescens was predominant among non-smokers (87.5%; p = 0.022). Conclusions: In young adults, the red-complex bacteria—Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola—were found more frequently and in larger quantities among smokers and vapers as compared to non-smokers. Full article

Background: Recent scientific evidence indicates that the oral–gut axis represents a critical interface in host–microbiota interactions, carrying profound implications for both periodontal and gastrointestinal diseases. This scoping review aims to evaluate the reciprocal influence between periodontitis and inflammatory bowel disease (IBD). Specifically, the underlying mechanisms of microbial translocation, immune interaction, and metabolite-mediated signaling linking the oral microbiota to gut microbial ecology are critically evaluated. Methods: Studies were selected from the PubMed, Web of Science, and Scopus databases up to May 2026. Eligible criteria included in vivo studies written in English and conducted within the last 10 years, whereas human studies involving participants under 18 years of age were excluded. The included studies analyze the effects of oral and gut dysbiosis on the opposing district. Through the database search, 2094 records were identified, and 34 articles were selected based on the eligibility criteria. Results: The included studies demonstrate the interconnection between the oral and gut microbiota. The included studies reveal that predominant oral taxa, specifically Porphyromonas gingivalis, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans, alter intestinal microbial composition. In particular, P. gingivalis colonizes the gut, exacerbating both oral and intestinal inflammation by stimulating pro-inflammatory cytokine expression via Th17 cell activation. Finally, salivary microbial composition appears to be associated with the presence and status of IBD. Conclusions: Understanding these interconnected microbial ecosystems provides valuable insights that may support the future development of integrated diagnostic and therapeutic strategies for patients suffering from periodontitis and IBD. Further large-scale studies with longer follow-up periods are required to standardize potential salivary markers and multidisciplinary therapeutic protocols for the management of periodontitis and IBD. Full article

Microbial fermentation of plant-derived materials is increasingly recognized as a strategy to enhance biological activity through phytochemical bioconversion. In this study, we investigated the antibiofilm effects of fermented Zingiber officinale rhizome extract against major periodontal pathogens and examined the underlying mechanisms. Ginger extract fermented with plant-derived lactic acid bacteria showed significantly greater inhibition of biofilm formation by Porphyromonas gingivalis, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans than non-fermented extract. The inhibitory activity increased with fermentation time, resulting in approximately 60–70% reduction in biofilm formation at higher concentrations. Chromatographic analysis revealed decreased 6-gingerol and increased 6-shogaol levels after fermentation, suggesting bioconversion of 6-gingerol to 6-shogaol. Direct treatment with 6-shogaol inhibited biofilm formation in a dose-dependent manner in all tested pathogens. Quantitative PCR analysis further showed that 6-shogaol significantly downregulated the quorum sensing-related gene luxS and multiple adhesion- and virulence-associated genes, including flp, fimA, mfa1, radD, fadA, ltxA, and rgpB. These findings indicate that lactic acid bacterial fermentation enhances the antibiofilm activity of ginger extract through increased 6-shogaol production, highlighting its potential as a natural anti-biofilm and anti-virulence agent for periodontal disease prevention and management. Full article

Background/Objectives: Aggregatibacter actinomycetemcomitans is an important periodontal pathogen whose biofilm formation and bacterial aggregation contribute to colonization and persistence within the oral cavity. This study aimed to generate random transposon mutants of A. actinomycetemcomitans and screen for alterations in biofilm- and aggregation-related phenotypes. Methods: A transposon mutagenesis library was created in the serotype d strain SA269 using the EZ-Tn5 transposon system. Transformants were screened in vitro for biofilm formation, autoaggregation, and coaggregation with Fusobacterium nucleatum. Biofilm biomass was quantified using a standardized microtiter plate assay, while aggregation assays were performed by optical density measurements. Results: Among 44 transformants, 12 exhibited a markedly reduced ability to form biofilms compared with the wild-type strain, indicating that disruption of certain loci compromises surface adherence and biofilm biomass accumulation. Five representative mutants were selected for aggregation studies. Three mutants showed reduced autoaggregation, suggesting impaired intraspecies cell–cell interactions, whereas four mutants demonstrated enhanced coaggregation with F. nucleatum, reaching approximately 50% coaggregation after 120 min. These findings indicate that insertional inactivation of genes in A. actinomycetemcomitans can differentially affect biofilm formation, autoaggregation, and interspecies coaggregation. Conclusions: This preliminary study demonstrates the utility of random transposon mutagenesis for identifying mutants with altered adhesion- and biofilm-related phenotypes. Although the disrupted genes were not identified, the mutant library provides a foundation for future molecular characterization of genetic determinants involved in biofilm development and microbial community interactions. Full article

Endodontic–periodontal lesions are complex conditions in which endodontic infection and periodontal breakdown coexist and may create anaerobic microbial niches along the root surface. Although smoking is a well-established modifier of periodontal disease progression and subgingival microbial ecology, its influence on the depth-related distribution of anaerobic periodontal bacteria in teeth affected by endodontic–periodontal lesions remains incompletely understood. This cross-sectional study investigated the distribution patterns and co-occurrence of selected anaerobic periodontal bacteria in smokers and non-smokers with endodontic–periodontal lesions, considering periodontal pocket depth and anatomical site. Subgingival samples were collected from periodontal pockets of different probing depths (3–4 mm, 5–6 mm, and ≥7 mm), as well as from healthy gingival sulci and oral mucosa, in 26 patients with endodontic–periodontal lesions. The presence of Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Prevotella nigrescens, and Aggregatibacter actinomycetemcomitans was assessed. Detection was performed using polymerase chain reaction (PCR). Qualitative detection frequencies and microbial co-occurrence patterns were compared between smokers and non-smokers across sites and pocket depths. Non-smokers showed higher detection of Tannerella forsythia in pockets ≥ 7 mm (p < 0.05). Overall microbial co-occurrence was lower in smokers in deeper periodontal pockets, whereas detection patterns in healthy gingival sulci and oral mucosa were broadly comparable between groups. Our findings suggest that smoking may be associated with an attenuated depth-related detection pattern and reduced co-occurrence of selected anaerobic periodontal bacteria in endodontic–periodontal lesions. Full article

Background: Full-mouth disinfection (FMD) has been proposed as an effective non-surgical approach for the management of periodontitis; however, its clinical and microbiological outcomes in patients with depressive comorbidity remain insufficiently explored. Methods: This prospective study included 80 patients diagnosed with stage II periodontitis, allocated into two groups based on the presence or absence of depressive disorder. All participants underwent standardized FMD. Clinical parameters, including bleeding on probing and plaque index, together with subgingival bacterial load (total bacterial load, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia), were assessed at baseline and 12 weeks post-treatment using quantitative polymerase chain reaction. Microbiological data were log10-transformed prior to statistical analysis. Results: Significant reductions in both clinical and microbiological parameters were observed following treatment in both groups. Improvements in bleeding on probing and plaque index were accompanied by a marked decrease in total bacterial load and in the targeted periodontal pathogens. Patients with depressive disorder exhibited a higher baseline microbial burden; however, post-treatment reductions were comparable between groups. Moderate positive correlations were identified between total bacterial load and clinical parameters. Conclusions: FMD was associated with substantial short-term improvements in both clinical and microbiological outcomes in patients with stage II periodontitis. Depressive comorbidity did not appear to adversely influence treatment response. These findings support the role of biofilm control as a central component of periodontal therapy across different patient profiles. Full article

Periodontitis (PD) and rheumatoid arthritis (RA) are chronic inflammatory disorders that impose substantial individual and societal burdens worldwide. PD is characterized by progressive destruction of the periodontal ligament and alveolar bone, leading to tooth loss, impaired oral function, and sustained systemic inflammatory burden. RA, affecting approximately 0.5–1% of the population, is a chronic autoimmune disease marked by persistent synovial inflammation, progressive joint destruction, disability, and reduced quality of life. Increasing evidence indicates that these conditions are biologically and clinically interconnected. Both diseases share key pathogenic pathways, including microbial dysbiosis, immune dysregulation, chronic inflammation, genetic susceptibility, and aberrant autoantibody responses. Particular attention has focused on keystone periodontal pathogens such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, which may promote protein citrullination and the formation of anti-citrullinated protein antibodies (ACPA), thereby providing a plausible mechanistic bridge between periodontal infection and systemic autoimmunity. Shared genetic risk factors, including HLA-DRB1 susceptibility alleles, further support a common host predisposition. Clinical, epidemiological, and translational studies increasingly support a bidirectional association. Individuals with PD appear to have a higher risk of RA development, whereas patients with RA demonstrate greater prevalence, severity, and progression of periodontal disease. Interventional studies suggest that nonsurgical periodontal therapy may reduce local periodontal inflammation, circulating inflammatory biomarkers, and RA disease activity indices, while effective pharmacological control of RA may also improve periodontal outcomes. This narrative review critically evaluates the PD–RA relationship across four interconnected domains: (i) epidemiological and clinical associations between PD and RA, (ii) key mechanisms underlying RA pathogenesis, (iii) shared biological pathways linking both diseases, and (iv) the extent to which treatment of one condition influences the other. Particular emphasis is placed on major sources of heterogeneity and confounding—including smoking, metabolic comorbidities, disease stage, therapeutic exposure, and variable diagnostic definitions—that may explain inconsistencies across the literature. By integrating current mechanistic and clinical evidence, this review provides a structured synthesis that extends beyond a descriptive overview of association studies. A clearer understanding of the periodontal–rheumatologic axis may facilitate risk stratification, identify novel therapeutic targets, and support integrated multidisciplinary care. Targeting both oral and systemic inflammation may improve outcomes in patients with coexisting PD and RA and may potentially reduce the risk or severity of one condition in individuals already affected by the other. Full article

Grade C molar-incisor pattern periodontitis (C-MIP) is a rapidly progressive form of periodontal disease affecting young individuals that is often linked to a highly virulent genotype of Aggregatibacter actinomycetemcomitans (Aa). Although Aa is present in the healthy oral microbiome, its transition into subgingival tissue correlates with the conversion from healthy to diseased status within the periodontal pocket. These changes may be due to immune evasion strategies attributed to Aa exotoxins. We previously demonstrated that a host cell protein, cellugyrin, plays a critical role in exotoxin internalization and subsequent cytotoxicity. Herein, we assess the contribution of cellugyrin to Aa phagocytosis and intracellular trafficking in human macrophages. Confocal imaging demonstrated that Aa co-localizes with cellugyrin. Importantly, cellugyrin-deficient macrophages exhibited a significant reduction in phagocytosed Aa. Furthermore, we analyzed the role of retrograde trafficking in Aa survival. Retro-2-mediated inhibition of this trafficking pathway resulted in increased intracellular Aa, likely due to increased survival. Collectively, our findings suggest that cellugyrin is involved in Aa phagocytosis and that retrograde trafficking may play a role in subsequent host cell clearance of Aa. Full article

This study investigated the antimicrobial potential of Coptis chinensis rhizome extract against key oral pathogens and evaluated the safety and clinical efficacy of a CCE-loaded mouthwash. CCE exhibited broad-spectrum bactericidal activity, with low minimum inhibitory concentrations (0.002–0.008%) and minimum bactericidal concentrations (0.004–0.016%) against Streptococcus mutans, Aggregatibacter actinomycetemcomitans, and Porphyromonas gingivalis. Time-kill kinetics revealed that CCE promptly eradicated Porphyromonas gingivalis. To balance antimicrobial potency and sensory acceptability, specifically the extract’s bitterness, we established the CCE concentrations in the mouthwash at 0.01% and 0.02% (w/v). Preclinical safety evaluations in animal models, including oral mucosal irritation and skin sensitization tests, confirmed the biocompatibility of 0.02% CCE, yielding “None” and “Non-sensitizer” ratings, respectively. Furthermore, a four-week, randomized, double-blind clinical trial (n = 73) revealed that 0.02% CCE mouthwash substantially reduced halitosis-inducing volatile sulfur compounds (hydrogen sulfide by 59.5% and methyl mercaptan by 50.0%). Significant improvements were also observed in the Plaque Index (55.2% reduction), Gingival Index (52.0% reduction), and Bleeding on Probing (77.3% reduction), with no adverse effects. These findings provide preliminary evidence that CCE mouthwash improves halitosis-related parameters and gingival indices in adults with self-reported halitosis, though further research is required to evaluate its long-term impact on broader periodontal disease states. Full article

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by systemic inflammation, synovial hyperplasia, and progressive joint destruction. Periodontitis, a chronic inflammatory disease affecting the supporting structures of teeth, has been increasingly recognized as a potential contributor to RA pathogenesis. Evidence suggests that both conditions share common immunological mechanisms and microbial triggers. This review summarizes the data linking RA with periodontitis, with particular focus on shared pathogenic pathways, microbial triggers, immune system alterations, and clinical relevance. Methods: Experimental, epidemiological, and clinical studies were evaluated to explore biological and clinical links between periodontitis and RA. Special emphasis was placed on the mucosal origins of RA, bacterial-mediated citrullination, autoantibody formation, and the role of the complement system. Results: Available epidemiological data indicate that individuals with RA present higher prevalence and greater severity of periodontitis. Periodontal pathogens, such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, contribute to immune dysregulation through citrullination, and subsequent production of anti-citrullinated protein antibodies (ACPAs), a hallmark of RA. Both diseases are characterized by chronic, uncontrolled inflammation, amplified by complement activation and neutrophil hyperactivity. Clinical evidence suggests that non-surgical periodontal therapy may reduce systemic inflammatory markers and improve RA disease activity. Conclusions: The relationship between RA and periodontitis appears to be bidirectional and the recognition of this interaction supports closer collaboration between rheumatologists and dental professionals. Future studies are required to clarify causality and determine whether management strategies can influence patient outcomes. Full article

Background/Objectives: Oral diseases remain among the most prevalent noncommunicable conditions worldwide, with biofilm-driven dysbiosis playing a central role in dental caries, gingivitis, periodontitis, and oral candidiasis. Curcumin has attracted considerable interest because of its anti-inflammatory, antioxidant, antimicrobial, and regenerative properties. However, its clinical use remains limited by poor water solubility, chemical instability, rapid metabolism, and low bioavailability. This review aimed to provide a comprehensive analysis of curcumin-based nanoformulations for oral health applications, with emphasis on their mechanistic actions, antibiofilm activity, and translational relevance. Methods: This review examined representative nanocarrier systems developed for curcumin delivery in oral health. These included polymeric nanoparticles, nanomicelles and nanoemulsions, solid lipid nanoparticles and nanostructured lipid carriers, nanogels, hydrogels, mucoadhesive films, and metallic or hybrid nanosystems. The analysis focused on molecular mechanisms of action, antimicrobial and antibiofilm effects against major oral pathogens, and key translational challenges. Results/Findings: Across the reviewed studies, nanoformulations consistently improved curcumin solubility, stability, tissue penetration, mucosal retention, and controlled release. Mechanistically, they enhanced anti-inflammatory activity through inhibition of nuclear factor kappa B (NF-κB), strengthened antioxidant defenses via the nuclear factor erythroid 2-related factor 2/heme oxygenase-1 (Nrf2/HO-1) axis, supported tissue repair and osteogenic responses, disrupted oral biofilms, and modulated local immune responses. Antimicrobial activity was reported against Streptococcus mutans, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Candida albicans, with reduced exopolysaccharide production, impaired adhesion, and improved biofilm penetration. Conclusions: Curcumin-based nanoformulations represent promising adjunctive platforms for oral healthcare. However, their clinical translation still requires improved stability in the oral-environment standardized manufacturing and characterization, rigorous safety evaluation, and well-designed controlled clinical studies. Full article

Objectives: Combining mechanical plaque control, the physical removal of oral biofilm, with chemical plaque control, the use of agents to inhibit biofilm formation, is effective in preventing periodontal disease. Chlorogenic acid (CGA) found in coffee beans has medicinal effects, such as anti-inflammatory and antibacterial properties. Periodontal pathogens are difficult to reach in certain areas with traditional self-care tools, such as toothbrushes. Additionally, the viscous biofilm is difficult to remove using mechanical plaque control alone. Therefore, this study aimed to evaluate the efficacy of CGA in chemical plaque control. Methods: The mRNA and protein expression of inflammatory cytokines in lipopolysaccharide (LPS)-stimulated human gingival fibroblasts (HGFs) and human periodontal ligament fibroblasts (HPDLs) in the presence of CGA were analyzed using reverse transcription-qPCR and enzyme-linked immunosorbent assay. Additionally, the proliferation levels of oral bacteria in the presence of CGA were evaluated. Results: CGA suppressed mRNA and protein expression levels of the inflammatory cytokines, interleukin (IL)-1β and IL-8, in HGFs and HPDLs stimulated with Porphyromonas gingivalis LPS. Furthermore, CGA inhibited bacterial proliferation of Streptococcus mutans, Aggregatibacter actinomycetemcomitans, P. gingivalis, and Fusobacterium nucleatum. Conclusions: This study demonstrated that CGA exhibits anti-inflammatory effects on gingiva and periodontal ligaments, and antibacterial effects against oral bacteria. These results indicate the potential application of CGA in chemical plaque control and suggest its use in preventing periodontal disease progression. Full article

Background/Objectives: Periodontitis is a chronic inflammatory disease characterized by complex interactions between periodontal pathogens and the host immune response. Pro-inflammatory cytokines, particularly interleukins, may influence bacterial colonization and disease expression, but their association with specific periodontal pathogens remains unclear. This study investigated the associations between single-nucleotide polymorphisms in IL-1A, IL-1B, and TNFA and the presence of key periodontopathogenic bacteria in patients from Croatia. Methods: A cross-sectional study included 63 participants. Genotypes were determined, and subgingival plaque samples were analyzed for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola using real-time PCR. Multivariable logistic regression models assessed associations between cytokine gene polymorphisms and periodontopathogenic bacteria presence, adjusting for age, gender, smoking status, and the presence of systemic diseases. Results: Among participants (median age 57.0 years, IQR 43.5–67.0; 58.7% female), P. intermedia (87.3%), T. forsythia (85.7%), and T. denticola (69.8%) were the most prevalent pathogens. The IL-1A CC genotype significantly increased the odds of P. gingivalis (OR = 5.54; p = 0.009) and T. denticola (OR = 3.77; p = 0.041) presence. The IL-1B CC genotype was independently associated with T. forsythia (OR = 8.48; p = 0.026). No significant associations were observed for TNFA polymorphism. Model performance ranged from moderate to good (AUC up to 0.89). Conclusions: Genetic variants in IL-1A and IL-1B may influence periodontal bacterial colonization, while demographic and lifestyle factors showed limited impact. Further studies in larger cohorts are warranted. Full article

Objectives: The present study evaluated the efficacy of a preparation based on bacterial lysates of Streptococcus oralis, Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum in the treatment of experimental periodontitis in rats, compared to metronidazole. Methods: Twenty female Wistar rats were used, divided into three groups: control, bacterial lysates and metronidazole, administered for 10 days by oral lavage/gavage. Periodontitis was induced by ligatures contaminated with bacterial suspensions (10⁹ CFU/mL) for 4 weeks. Lysates were obtained by culturing bacterial strains, centrifugation, washing, heat inactivation, ultrasonication and filtration. The evaluations included biocompatibility on HGF-1 fibroblasts, microbiological stability, clinical parameters, hematological, biochemical and histopathological analyses. Results: The lysates demonstrated the absence of cytotoxicity (cell viability 90–100%) and significant antimicrobial effect at the optimal concentration (2 × 10⁹ CFU/mL equivalent). Both treatments significantly reduced periodontal inflammation, with no statistical differences between them. Systemic immunoinflammatory indices (SII, SIRI, AISI) increased comparably, demonstrating controlled immune mobilization, and ALT was maintained within physiological limits. Histopathological examination revealed a reduction in inflammatory infiltrate, connective tissue reorganization and bone regeneration in both treated groups. Conclusions: Bacterial lysates represent a viable therapeutic alternative with comparable efficacy to metronidazole, favorable safety profile and immunomodulatory potential in the treatment of periodontitis. Full article