Citation Information :
Ashwini S, Prasad K, Sujini BK. Assessment of Porphyromonas gingivalis and Filifactor alocis Levels in Gestational Diabetes Mellitus Patients with Periodontitis Post Nonsurgical Periodontal Therapy. World J Dent 2022; 13 (S2):S161-S169.
Aim: To evaluate the effect of nonsurgical periodontal therapy (NSPT) on microbial alterations (Porphyromonas gingivalis and Filifactor alocis), in pregnant periodontitis study participants with and without gestational diabetes mellitus (GDM).
Materials and methods: The present study has been designed as a prospective and interventional trial. A total of 120 pregnant women were selected according to predetermined inclusion and exclusion criteria. Group I included pregnant study participants with GDM and periodontitis, who underwent oral hygiene instructions (OHI) throughout the study. Group II had pregnant study participants with GDM and periodontitis, who underwent scaling and root planning (SRP), followed by OHI. Group III had pregnant study participants with periodontitis maintained on OHI, and group IV had pregnant study participants with periodontitis who underwent SRP, followed by OHI.
After the patients were categorized into respective groups, subgingival plaque samples were collected. All the patients were given OHI, and patients in groups II and IV underwent SRP. Clinical parameters were reevaluated 3 months after NSPT, before parturition. Subgingival plaque samples were also collected at the follow-up appointment. The study data was analyzed using Statistical Package for Social Sciences (SPSS) software V.22, IBM, for Windows.
Results: An improvement in the microbial load was observed in all patients. However, better improvement was observed in group II, which included patients with GDM and periodontitis, who were provided with NSPT and OHI.
Conclusion: Nonsurgical periodontal therapy (NSPT) in pregnant periodontitis study participants with and without GDM demonstrated a reduction in P. gingivalis and F. alocis loads. The results are in accordance with the hypothesis of the current study, suggesting a positive impact of NSPT on microbial load and its effect on periodontal status.
Clinical Significance: The detrimental effect of microorganisms on host periodontal tissues lead to periodontitis. After NSPT, there was a reduction in the microbiological load with an improvement in the clinical periodontal parameters, thereby improving the oral health of the study participants.
Kornman KS, Loesche WJ. The subgingival microbial flora during pregnancy. J Periodontal Res 1980;15(2):111–122. DOI: 10.1111/j.1600-0765.1980.tb00265.x
Schlafer S, Riep B, Griffen AL, et al. Filifactor alocis – involvement in periodontal biofilms. BMC Microbiol 2010;10(1):66. DOI: 10.1186/1471-2180-10-66
Aagaard K, Ma J, Antony KM, et al. The placenta harbors a unique microbiome. Sci Transl Med 2014;6(237):237ra65. DOI: 10.1126/scitranslmed.3008599
Souccar NM, Chakhtoura M, Ghafari JG, et al. Porphyromonas gingivalis in dental plaque and serum C-reactive protein levels in pregnancy. J Infect Dev Ctries 2010;4(6):362–366. DOI: 10.3855/jidc.1031
Aja E, Mangar M, Fletcher HM, et al. Filifactor alocis: recent insights and advances. J Dent Res 2021;100(8):790–797. DOI: 10.1177/00220345211000656
León R, Silva N, Ovalle A, et al. Detection of Porphyromonas gingivalis in the amniotic fluid in pregnant women with a diagnosis of threatened premature labor. J Periodontol 2007;78(7):1249–1255. DOI: 10.1902/jop.2007.060368
Bendek MJ, Canedo-Marroquín G, Realini O, et al. Periodontitis and gestational diabetes mellitus: a potential inflammatory vicious cycle. Int J Mol Sci 2021;22(21):11831. DOI: 10.3390/ijms222111831
Makiura N, Ojima M, Kou Y, et al. Relationship of Porphyromonas gingivalis with glycemic level in patients with type 2 diabetes following periodontal treatment. Oral Microbiol Immunol 2008;23(4):348–351. DOI: 10.1111/j.1399-302X.2007.00426.x
Ercan E, Eratalay K, Deren O, et al. Evaluation of periodontal pathogens in amniotic fluid and the role of periodontal disease in pre-term birth and low birth weight. Acta Odontol Scand 2013;71(3–4):553–559. DOI: 10.3109/00016357.2012.697576
Hajishengallis G. Immune evasion strategies of Porphyromonas gingivalis. J Oral Biosci 2011;53(3):233–240. DOI: 10.2330/joralbiosci.53.233
Aruni AW, Mishra A, Dou Y, et al. Filifactor alocis – a new emerging periodontal pathogen. Microbes Infect 2015;17(7):517–530. DOI: 10.1016/j.micinf.2015.03.011
Aruni AW, Zhang K, Dou Y, et al. Proteome analysis of coinfection of epithelial cells with Filifactor alocis and Porphyromonas gingivalis shows modulation of pathogen and host regulatory pathways. Infect Immun 2014;82(8):3261–3274. DOI: 10.1128/IAI.01727-14
Socransky SS, Haffajee AD, Cugini MA, et al. Microbial complexes in subgingival plaque. J Clin Periodontol 1998;25(2):134–144. DOI: 10.1111/j.1600-051x.1998.tb02419.x
Gogeneni H, Buduneli N, Ceyhan-Öztürk B, et al. Increased infection with key periodontal pathogens during gestational diabetes mellitus. J Clin Periodontol 2015;42(6):506–512. DOI: 10.1111/jcpe.12418
Fujiwara N, Tsuruda K, Iwamoto Y, et al. Significant increase of oral bacteria in the early pregnancy period in Japanese women. J Investig Clin Dent 2017;8(1):e12189. DOI: 10.1111/jicd.12189
Romano-Keeler J, Weitkamp JH. Maternal influences on fetal microbial colonization and immune development. Pediatr Res 2015;77(1–2):189–195. DOI: 10.1038/pr.2014.163
Zhang Z, Liu S, Zhang S, et al. Porphyromonas gingivalis outer membrane vesicles inhibit the invasion of Fusobacterium nucleatum into oral epithelial cells by downregulating FadA and FomA. J Periodontol 2022;93(4):515–525. DOI: 10.1002/JPER.21-0144
Gómez LA, De Avila J, Castillo DM, et al. Porphyromonas gingivalis placental atopobiosis and inflammatory responses in women with adverse pregnancy outcomes. Front Microbiol 2020;11:591626. DOI: 10.3389/fmicb.2020.591626
Tellapragada C, Eshwara VK, Acharya S, et al. Prevalence of clinical periodontitis and putative periodontal pathogens among South Indian pregnant women. Int J Microbiol 2014;2014:420149. DOI: 10.1155/2014/420149
Newman MG, Takei H, Klokkevold PR, et al. Newman and Carranza's Clinical periodontology E-book. Elsevier Health Sciences; 2018 May 29.