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Subgingival microflora in inflammatory bowel disease patients with untreated periodontitis

Brito, Fernandaa; Zaltman, Cyrlac; Carvalho, Ana T.P.b; Fischer, Ricardo G.a; Persson, Rutgerd,e; Gustafsson, Andersf; Figueredo, Carlos M.S.a,f

European Journal of Gastroenterology & Hepatology: February 2013 - Volume 25 - Issue 2 - p 239–245
doi: 10.1097/MEG.0b013e32835a2b70
Original Articles: Inflammatory Bowel Diseases

Objective To analyze the subgingival microflora composition of inflammatory bowel disease (IBD) patients with untreated chronic periodontitis and compare them with systemically healthy controls also having untreated chronic periodontitis.

Method Thirty IBD patients [15 with Crohn’s disease (CD) and 15 with ulcerative colitis (UC)] and 15 control individuals participated in the study. All patients had been diagnosed with untreated chronic periodontitis. From every patient, subgingival plaque was collected from four gingivitis and four periodontitis sites with paper points. Samples from the same category (gingivitis or periodontitis) in each patient were pooled together and stored at −70°C until analysis using a checkerboard DNA–DNA hybridization technique for 74 bacterial species.

Results Multiple-comparison analysis showed that the groups differed in bacterial counts for Bacteroides ureolyticus, Campylobacter gracilis, Parvimonas micra, Prevotella melaninogenica, Peptostreptococcus anaerobius, Staphylococcus aureus, Streptococcus anginosus, Streptococcus intermedius, Streptococcus mitis, Streptococcus mutans, and Treponema denticola (P<0.001). CD patients had significantly higher levels of these bacteria than UC patients either in gingivitis or in periodontitis sites (P<0.05). CD patients harbored higher levels of P. melaninogenica, S. aureus, S. anginosus, and S. mutans compared with controls both at gingivitis and at periodontitis sites (P<0.05). UC patients harbored higher levels of S. aureus (P=0.01) and P. anaerobius (P=0.05) than controls only in gingivitis sites.

Conclusion Our study showed that even with similar clinical periodontal parameters, IBD patients harbor higher levels of bacteria that are related to opportunistic infections in inflamed subgingival sites that might be harmful for the crucial microbe–host interaction.

aDepartament of Periodontology, Faculty of Odontology

bDepartment of Gastroenterology, Faculty of Medicine, Rio de Janeiro State University

cDepartment of Gastroenterology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

dDepartment of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland

eDepartment of Oral Medicine, School of Dentistry, University of Washington, Seattle, Washington, USA

fDepartment of Dental Medicine, Division of Perisodontology, Karolinska Institutet, Stockholm, Sweden

Correspondence to Carlos M.S. Figueredo, PhD, Departament of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Boulevard 28 de Setembro 157, Pavilhão de Pesquisa, Vila Isabel, Rio de Janeiro 20551-030, Brazil Tel/fax: +55 212 868 8642; e-mail:

Received July 12, 2012

Accepted September 5, 2012

© 2013 Lippincott Williams & Wilkins, Inc.