Ricerc@Sapienza

BACKGROUND: The term microbiome signifies “the ecological
community of commensal, symbiotic, and pathogenic
microorganisms that literally share our body space and
have been all but ignored as determinants of health and disease”
(1). The association between the oral microbiome and
periodontal diseases is still unclear. The aim of the present
study was to perform a systematic review and meta-analysis
of the existing literature to (i) identify the association between
the variation of the oral microbiome and periodontitis;
and (ii) to estimate the risk of developing inflammation of
the periodontal space in subjects who present a specific variation
of the taxonomy of the oral microbiome.
Methods: This systematic review was conducted according
to the PRISMA statement (2) and the Cochrane Handbook for
Systematic Reviews of Interventions (3). Literature searches
of free text and MeSH terms were performed by using
MedLine (PubMed) and Scopus (30th May 2017). Articles
from 1950 were searched using the following keywords: A)
[(“oral flora” OR “oral ecosystem” OR “dental microflora”
OR “microbial consortium”) AND (“periodontitis” OR “periodontal
inflammation”)]; B) [(“oral flora” OR “oral ecosystem”
OR “dental microflora” OR “microbial consortium”)].
The search strategy identified 275 potential articles, 99 from
Pubmed and 176 from Scopus. After removal of duplicates,
170 articles were analyzed. Subsequently, 146 papers were
excluded because they did not meet the inclusion criteria.
Of the remaining 24 papers, 7 were excluded because not
relevant to the subject of the study. The remaining 17 papers
were included in the qualitative synthesis, and 11 of them in
the meta-analysis (Fig 1).
RESULTS: 11 RCTs involving 2111 patients were included.
The retrieved case-control studies evaluated the presence or
absence of different targeted pathogens. Among the microrganisms
evaluated Porphyromonas gengivalis [OR (95%
CI) 2.93(0.98,8.87); P< 0.0001] and Streptococcus mutans
[OR (95% CI) 1.77 (0.89-3.54); P=0.03] were found to
be risk factors for the development of periodontitis, while
Aggregatibacter actinomycetemcomitans [OR (95% CI) 0.52
(0.33-0.83)] played a protective role for periodontitis.
Conclusions: Our results show that Porphyromonas gengivalis
and Streptococcus mutans were found to be associated
with an increased risk for the development of periodontitis,
while Aggregatibacter actinomycetemcomitans was found to
be protective for periodontitis. Better understanding of the
relationship between oral microflora composition and host
oral and systemic conditions (plaque, calculus, oral hygiene
behaviors, smoking) in health and disease can be of value to
develop new diagnostic and therapeutic tools, which could be
oriented toward a more topic or holistic approach.