Longitudinal analysis of the subgingival microbiome following enamel matrix derivate therapy

Abstract

Periodontitis is a polymicrobial infection that destroys the structures anchoring the tooth to the jawbone and results in eventual tooth loss. This disease affects 65% of individuals over 40 years of age and has been consistently associated with several potentially life-threatening diseases including coronary heart disease, pre-term births, diabetes and cerebrovascular accidents. Subgingival bacteria are the primary etiologic agents of periodontitis. Evidence is emerging that Enamel Matrix Derivative (EMD) is capable of regenerating lost periodontal tissues both by stimulating stem cells within the periodontal ligament and through an antimicrobial activity. Although the regenerative mechanisms of EMD have been well elucidated, the antimicrobial effects have been poorly characterized. Recent studies, including our own investigations, have shown that more than 70% of the subgingival microbiome is uncultivated and therefore, unrecognized. Accordingly, a comprehensive examination of this complex ecosystem requires an approach that would identify all species in the community, including previously uncultivated, unknown and unsuspected organisms. We propose studies that combine a randomized clinical study design with high-throughput molecular microbiology to elucidate the effects of EMD on subgingival bacteria. (AU)