Faculty Bibliography

SUBJECTS: Enrollment and study protocols took place between June 2002 and October 2005. This study was a supplemental project of a larger trial of cohorts recruited from university settings in Lincoln, Nebraska, and Stony Brook, New York. Female postmenopausal participants who had osteopenia and a history of moderate to advanced chronic periodontitis comprised the test group (n = 51; at baseline, n = 63) and placebo group (n = 62; at baseline, n = 64) after a 2-year study period. KEY EXPOSURE/STUDY FACTOR: Participants were allocated to a test group or a placebo group. Participants who belonged to the test group received subantimicrobial-dose-doxycycline (SDD)(20 mg of doxycycline hyclate) twice daily for 2 years. Participants in the control group received a look-alike placebo twice a day for 2 years. In addition, all patients received periodontal maintenance (every 3-4 months for the duration of the study) and were provided with a supply to be taken twice daily for the duration of the study of calcium (1200 mg) and vitamin D (400 IU). MAIN OUTCOME MEASURE: Markers of systemic inflammation (hs-CRP, myeloperoxidase, MMP-8, TIMP-1, MMP-9, MMP-2, IL-6, TNF-alpha, and IL-1beta) and lipid profiles (total cholesterol, HDL, LDL and VLDL cholesterol, and triglycerides). MAIN RESULTS: The combined treatment modalities (SDD + periodontal maintenance + dietary supplement) reduced hs-CRP levels as expressed by ratio of medians (SDD/placebo) by 18% compared with placebo (periodontal maintenance + dietary supplement) (0.82; confidence interval [CI] = 0.700.97; P = .02) after the 2-year study period when adjusting for the use of concomitant medications (statin, diuretics, aspirin). The combined treatment modalities significantly reduced MMP-9 (mean scanning units of treatment minus placebo) relative to placebo over the 2-year protocol (-28.44; CI = -40.17 to -16.72, P < .001). There were no statistically significant differences of lipid profiles between the combined treatment modalities and placebo group after a 2-year protocol. CONCLUSIONS: SDD when used as an adjunctive to periodontal maintenance plus dietary supplement significantly lowers serum biomarkers of inflammation in postmenopausal women with history of periodontitis.

OBJECTIVE.: To profile the subgingival oral microbiota abundance and diversity in never-treated, new-onset rheumatoid arthritis (NORA) patients. METHODS.: Periodontal disease (PD) status, clinical activity and sociodemographic factors were determined in patients with NORA, chronic RA (CRA) and healthy subjects. Massively parallel pyrosequencing was used to compare the composition of subgingival microbiota and establish correlations between presence/abundance of bacteria and disease phenotypes. Anti-P. gingivalis antibodies were tested to assess prior exposure. RESULTS.: The more advanced forms of periodontitis are already present at disease onset in NORA patients. The subgingival microbiota of NORA is distinct from controls. In most cases, however, these differences can be attributed to PD severity and are not inherent to RA. The presence and abundance of P. gingivalis is directly associated with PD severity as well, is not unique to RA, and does not correlate with anti-citrullinated peptide antibody (ACPA) titers. Overall exposure to P. gingivalis is similar in RA and controls, observed in 78.4% and 83.3%, respectively. Anaeroglobus geminatus correlated with ACPA/RF presence. Prevotella and Leptotrichia species are the only characteristic taxa in the NORA group irrespective of PD status. CONCLUSIONS.: NORA patients exhibit a high prevalence of PD at disease onset, despite their young age and paucity of smoking history. The subgingival microbiota of NORA patients is similar to CRA and healthy subjects of comparable PD severity. Although colonization with P. gingivalis correlates with PD severity, overall exposure is similar among groups. The role of A. geminatus and Prevotella/Leptotrichia species in this process merits further study.

Propolis, a natural bee product widely used for its antimicrobial activity, was tested against isolates of Enterococcus from humans, pig-tailed macaques, isolates of refractory endodontic treatment cases, and isolates from Lactobacillus-containing food supplements. Typification of the propolis was performed by high-performance liquid chromatography (HPLC) by which prenylated compounds, cinnamic acid derivatives, and flavonoids were detected as the main constituents. Minimum inhibitory concentrations (MIC) were determined using the agar dilution method. All human and animal Enterococcus isolates demonstrated MIC values of 1600 microg/mL. Enterococcal species of human and animal origin were inhibited by propolis. Particularly, human isolates of E. faecium and E. faecalis of refractory endodontic treatment cases were susceptible to propolis of Brazilian origin.

This study aimed to: (1) determine concordance rates of self-reported and subjectively determined indicators of oral malodor in twins; (2) determine the relative contributions of genetic and environmental factors to levels of volatile sulfur compounds (VSCs) in intraoral and exhaled breath. Fifty-one twin pairs participated in the study. Measurements of VSCs were obtained by a halimeter. The presence of tongue coatings was determined and twins filled out a 32-item questionnaire on oral malodor indicators independently of one another. Estimates of heritability (h2) for halimeter measurements were computed by SOLAR. The concordance rates for the presence of tongue coating among identical and fraternal twins were 67% and 11%, respectively. In the 10 most informative items, 70% exhibited higher concordance rates for identical than for fraternal twins. Of particular interest were the differences in concordance rates for dry mouth, sinus infection and unusual sweating. The h2 for intraoral breath was 0.28 +/- 0.17 (NS), whereas the h2 for exhaled breath was 0.50 +/- 0.20 (p = .0207). The concordance rates of tongue coatings and malodor indicators were higher in identical twins than in fraternal twins. Intraoral breath VSC values were primarily attributable to environmental factors, whereas exhaled breath VSC values were partially explained by genetic factors.

The purpose of this study was to provide a univariate and multivariate analysis of genomic microbial data and salivary mass-spectrometry proteomic profiles for dental caries outcomes. In order to determine potential useful biomarkers for dental caries, a multivariate classification analysis was employed to build predictive models capable of classifying microbial and salivary sample profiles with generalization performance. We used high-throughput methodologies including multiplexed microbial arrays and SELDI-TOF-MS profiling to characterize the oral flora and salivary proteome in 204 children aged 1-8 years (n = 118 caries-free, n = 86 caries-active). The population received little dental care and was deemed at high risk for childhood caries. Findings of the study indicate that models incorporating both microbial and proteomic data are superior to models of only microbial or salivary data alone. Comparison of results for the combined and independent data suggests that the combination of proteomic and microbial sources is beneficial for the classification accuracy and that combined data lead to improved predictive models for caries-active and caries-free patients. The best predictive model had a 6% test error, >92% sensitivity, and >95% specificity. These findings suggest that further characterization of the oral microflora and the salivary proteome associated with health and caries may provide clinically useful biomarkers to better predict future caries experience.