IADR Abstract Archives
Microbial Dysbiosis and Systemic Inflammation in Men With Apical Periodontitis
Objectives: The contribution of apical periodontitis (AP), to systemic inflammation has been reported, but the mechanism is yet to be identified. This study aimed to investigate associations of AP with microbial dysbiosis measured by Next Generation Sequencing (NGS) of the 16S gene, and levels of systemic inflammation measured by high sensitivity C-reactive protein (CRP), in a cohort of 60–70-year-old men in Northern Ireland enrolled in the Prospective Epidemiological Study of Myocardial Infarction (PRIME) study.
Methods: Periapical status was assessed from dental orthopantomograms (OPT) using the periapical index. Men with AP were divided into HIGH (> 25%) and LOW (<25% of teeth with AP). The AP microbial dysbiosis index (APMDI) was based on NGS DeSeq analysis and calculated as a log of total abundance of micro-organisms decreased in AP divided by total abundance of micro-organisms increased in AP for all samples. CRP was categorised into low (<1.0mg/l), average (1.0-3.0mg/l); and high (>3.0mg/l). Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI).
Results: For CRP analysis, 51 (27.7%) of the 184 men in the HIGH AP group were in the high CRP category compared with 188 (18.95%) of the 992 with LOW AP (chi-square=7.35, p<0.01). Adjusting for age, BMI, smoking, diabetes and mean attachment loss, the OR for men in the HIGH AP group to have high CRP was 1.56 (95% CI 1.06-2.27), p=0.02. Analysis of NGS 16S data identified a shift in the APMDI in the HIGH AP group (t test p=0.025). This shift was associated with increased Streptococcus mutans and Veillonella spp. The APMDI shift observed in AP was associated with high CRP levels (t test p=0.004).
Conclusions: Men with high levels of AP were at an increased risk of having high CRP. A microbial shift in AP, characterised by increased S. mutans and Veillonella spp, was associated with systemic inflammation in this representative sample of men from Northern Ireland.
Methods: Periapical status was assessed from dental orthopantomograms (OPT) using the periapical index. Men with AP were divided into HIGH (> 25%) and LOW (<25% of teeth with AP). The AP microbial dysbiosis index (APMDI) was based on NGS DeSeq analysis and calculated as a log of total abundance of micro-organisms decreased in AP divided by total abundance of micro-organisms increased in AP for all samples. CRP was categorised into low (<1.0mg/l), average (1.0-3.0mg/l); and high (>3.0mg/l). Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI).
Results: For CRP analysis, 51 (27.7%) of the 184 men in the HIGH AP group were in the high CRP category compared with 188 (18.95%) of the 992 with LOW AP (chi-square=7.35, p<0.01). Adjusting for age, BMI, smoking, diabetes and mean attachment loss, the OR for men in the HIGH AP group to have high CRP was 1.56 (95% CI 1.06-2.27), p=0.02. Analysis of NGS 16S data identified a shift in the APMDI in the HIGH AP group (t test p=0.025). This shift was associated with increased Streptococcus mutans and Veillonella spp. The APMDI shift observed in AP was associated with high CRP levels (t test p=0.004).
Conclusions: Men with high levels of AP were at an increased risk of having high CRP. A microbial shift in AP, characterised by increased S. mutans and Veillonella spp, was associated with systemic inflammation in this representative sample of men from Northern Ireland.