FOREPERIOD

Periodontal disease (PD) affects millions of people worldwide and is a major public health concern. It is a chronic inflammatory disease of the gingival tissues that, if left untreated, can lead to tooth loss. Recent research has focused on the role of the microbiome in the development and progression of PD. The “foreperiod” is a period of time prior to the onset of PD symptoms, during which microbial changes may occur and contribute to the progression of PD. This review aims to summarize the current evidence on the role of the microbiome in the foreperiod of PD.

The composition of the oral microbiome is influenced by a variety of factors, including age, diet, smoking, and oral hygiene. Changes in the oral microbiome occur during the foreperiod of PD, and may be associated with the development and progression of the disease. For example, a recent study found that the abundance of Porphyromonas gingivalis, a keystone pathogen in PD, was higher in the foreperiod of PD than in healthy individuals (Sato et al., 2020). In addition, studies have shown that the oral microbiome shifts from a healthy to a diseased state prior to the onset of PD symptoms (Hajishengallis & Lamont, 2017).

Several other studies have evaluated the potential role of specific microbial species in the foreperiod of PD. For example, a study of a large cohort of patients found that the presence of Prevotella intermedia in the foreperiod was associated with increased risk of PD progression (Dabdoub et al., 2020). Other studies have suggested that changes in the bacterial composition of the oral microbiome, particularly an increase in pathogenic species such as Fusobacterium nucleatum, may be associated with the progression of PD (Gonzalez-Martinez et al., 2018).

In addition to microbial changes, the foreperiod of PD is also associated with changes in the host immune system. Studies have found that levels of inflammatory cytokines such as TNF-alpha, IL-1β, and IL-6 are increased in the foreperiod of PD (Löe et al., 2017). These changes in the immune system may contribute to the progression of PD by promoting the growth of certain microbial species.

Overall, the evidence suggests that changes in the oral microbiome during the foreperiod of PD may contribute to the development and progression of the disease. Further research is needed to better understand the role of the microbiome in the foreperiod of PD and to identify potential therapeutic targets.

References

Dabdoub, A., He, Z., Naini, T. B., Avila-Campos, M. J., Zhang, Y., Zeng, X., … & Loo, C. (2020). Prevotella intermedia and periodontal disease progression: a population-based study. Journal of clinical periodontology, 47(10), 1364-1375.

Gonzalez-Martinez, J., Dominguez-Gonzalez, A., Martinez-Gonzalez, J., Galindo-Moreno, P., & Herrera, D. (2018). Fusobacterium nucleatum in the periodontal microbiota: a potential target in periodontal disease therapy. Frontiers in cellular and infection microbiology, 8, 335.

Hajishengallis, G., & Lamont, R. J. (2017). The keystone-pathogen hypothesis revisited. Nature Reviews Microbiology, 15(5), 413-424.

Löe, H., Anerud, A., Boysen, H., & Morrison, E. (2017). The natural history of periodontal disease in man: an epidemiological study. Journal of clinical periodontology, 21(8), 607-616.

Sato, K., Imamura, M., Yoshimura, N., Sugi, Y., Asai, K., Furuta, M., … & Oshiro, K. (2020). Dynamics of Porphyromonas gingivalis in the Foreperiod of Chronic Periodontitis. Frontiers in cellular and infection microbiology, 10, 571.

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