Santhana Krishnan Gayathri, Naik Dilip, Uppoor Ashita, Nayak Sangeeta, Baliga Shrikala, Maddi Abhiram
Department of Periodontology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Microbiology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
PeerJ. 2020 Jan 29;8:e8441. doi: 10.7717/peerj.8441. eCollection 2020.
Studies of gum or periodontal disease have focused mainly on bacterial pathogens. However, information related to fungal species in the saliva and subgingival mileu is particularly lacking in smokers with periodontitis. This cross-sectional study compared the prevalence of various species in saliva and subgingival plaque samples of smokers and non-smokers with periodontal disease.
Study subjects were recruited into three group-Group 1: Smokers with chronic periodontitis ( = 30), Group 2: Non-smokers with chronic periodontitis ( = 30) and Group 3: Healthy controls ( = 30). Clinical parameters recorded included plaque index (PI), gingival index (GI), periodontal probing depth (PPD) and clinical attachment loss (CAL). Saliva and subgingival plaque samples were collected from subjects from the above groups. The collected samples were processed for isolation and identification of various species using CHROMagar chromogenic media. Additionally, antifungal susceptibility tests were performed for the isolated species in order to assess antifungal drug resistance to fluconazole and voriconazole.
Prevalence of species in saliva samples was quantified as 76.6% in Group 1, 73.3% in Group 2 and 36.6% in Group 3 and statistically significant differences were observed between groups 1 & 3. Prevalence of species in subgingival plaque samples was quantified as 73.3% in Group 1, 66.6% in Group 2 and 60% in Group 3 and no statistically significant differences were observed between groups. was the most frequently isolated species followed by and . A positive correlation was observed for smoking exposure, pack years and colonization. A marginally significant positive correlation was observed between colonization and increasing pocket depth and attachment loss. Antifungal drug resistance was mainly observed for in both saliva and subgingival plaque samples.
Based on the results we can conclude that oral candidal carriage is significantly increased in smokers with periodontal disease. Mechanistic studies are needed to understand the importance of species in periodontal disease.
牙龈或牙周疾病的研究主要集中在细菌病原体上。然而，在患有牙周炎的吸烟者中，关于唾液和龈下环境中真菌种类的信息尤其缺乏。这项横断面研究比较了患有牙周疾病的吸烟者和非吸烟者唾液及龈下菌斑样本中各种真菌的患病率。
研究对象被分为三组——第一组：患有慢性牙周炎的吸烟者（n = 30），第二组：患有慢性牙周炎的非吸烟者（n = 30），第三组：健康对照者（n = 30）。记录的临床参数包括菌斑指数（PI）、牙龈指数（GI）、牙周探诊深度（PPD）和临床附着丧失（CAL）。从上述组别的受试者中收集唾液和龈下菌斑样本。使用CHROMagar显色培养基对收集的样本进行处理，以分离和鉴定各种真菌。此外，对分离出的真菌进行抗真菌药敏试验，以评估其对氟康唑和伏立康唑的耐药性。
唾液样本中真菌的患病率在第一组中为76.6%，第二组中为73.3%，第三组中为36.6%，在第一组和第三组之间观察到统计学上的显著差异。龈下菌斑样本中真菌的患病率在第一组中为73.3%，第二组中为66.6%，第三组中为60%，各组之间未观察到统计学上的显著差异。白色念珠菌是最常分离出的菌种，其次是热带念珠菌和光滑念珠菌。观察到吸烟暴露、吸烟包年数与念珠菌定植之间呈正相关。在念珠菌定植与牙周袋深度增加和附着丧失之间观察到微弱的显著正相关。在唾液和龈下菌斑样本中，主要观察到白色念珠菌的耐药性。
根据结果我们可以得出结论，患有牙周疾病的吸烟者口腔念珠菌携带率显著增加。需要进行机制研究以了解念珠菌在牙周疾病中的重要性。
