Background: The prevalence of aggressive periodontal disease in children and young adults in the U.S. is around 1 to 2%, and the disease has a higher prevalence in blacks. Different microbiota have been associated with the disease, but the role of specific periodontal pathogens in the destructive process is not clear. The authors identified a cohort of African-American children diagnosed with localized aggressive periodontitis (LAP) in one clinical setting. The objective of this study was to characterize the microbial profiles of 31 LAP children, 11 healthy siblings, and 9 healthy unrelated control children. LAP was defined by the presence of less than 30% of sites but at least 2 teeth [incisor and/or first molar, but no more than 2 teeth other than first molar and incisors (Armitage, 1999)] with PD ≥ 5 mm in the presence of interproximal attachment loss and ≥ 2 mm bone loss detected on radiographic examination. Healthy participants were defined by the absence of pocket depth > 4 mm in the presence of attachment/bone loss (pseudo/gingival pockets with no attachment/bone loss were allowed). Subgingival plaque samples were taken from diseased and healthy sites in the children with LAP and from healthy sites in the healthy siblings and unrelated controls, and analyzed by 16S rRNA-based microarrays.
Advance: Two species of Aggregatibacter actinomycetemcomitans (Aa) were the only species found to be both more prevalent (for Aa_ot531_AA84, OR = 8.33, CI = 2.11-32.90, p = 0.0025; for Aa_ot531_P02, OR = 5.82, CI = 1.79-18.97, p = 0.0034) and abundant (p < 0.001) in diseased sites. Aa was found to be very site-specific, since it was more prevalent and abundant in diseased vs. healthy sites in LAP. Filifactor alocis (Fa) was also found to be more prevalent in diseased sites (OR = 2.31, CI = 1.06-5.01, p = 0.03). Species present in larger quantities and proportions in healthy sites, including in an individual with disease, included Selenomonas sp, Veillonella, and Streptococcus. Some species not typically detected, such as Bergeyella sp, Kingella oralis, and Neisseria sp, were frequently found in healthy controls and healthy siblings. Overall, Streptococcus spp, Campylobacter gracilis, Capnocytophaga granulosa, Haemophilus parainfluenzae, and Lautropia mirabilis were most abundant in healthy children, while Aa, Fa, Tannerella sp, Solobacterium moorei, Parvimonas micra, and Capnocytophaga sp were most abundant in LAP. Longitudinal evaluation of this LAP cohort could lead to important understanding of the destructive and protective roles of bacteria in the initiation and progression of LAP.
Public Impact Statement/Significance: Although the prevalence of LAP is relatively low and is apparently confined to specific susceptible groups, early stages of this disease could easily go underdiagnosed until clearer signs of alveolar bone loss are detected in radiographic examination. Therefore, the detection of specific bacteria associated with this disease in children at a young age, before disease breakdown occurs, might be desirable for the successful prevention and/or treatment of this disease in those with high risk for its development.
Publication Citation: Shaddox LM, Huang H, Lin T, Hou W, Harrison PL, Aukhil I, Walker CB, Klepac-Ceraj V, Paster BJ (2012). Microbiological characterization in children with aggressive periodontitis. J Dent Res, 91(10):927-33.