Methicillin‐resistant staphylococci carriage in the oral cavity: a study conducted in Bari (Italy)

Oral Diseases (2010) 16 , 465–468 Objectives: The oral cavity may represent a site of colonization by antibiotic‐resistant bacteria, such as methicillin‐resistant staphylococci (MRS). To define the prevalence of staphylococci and MRS in the oral cavity, an observational study was carried out in the city of Bari (Italy). Methods: Sixty subjects were asked to provide oral samples and a questionnaire about risk factors of colonization by MRS. An enrichment medium specific for staphylococci was used for the isolation. Results: Swabs and corresponding questionnaires were available from 36 out of 60 patients. Staphylococci were isolated from seven out of 36 samples (prevalence 19.4%). Among the seven staphylococcal isolates, three were Staphylococcus aureus, and one strain, belonging to S. epidermidis species, was found to be MR (1.7%). No methicillin‐resistant S. aureus were isolated. Five out of seven staphylococcal isolates exhibited resistance to more than two classes of non‐beta‐lactams antimicrobials. None of the risk factors analysed correlated with the status of MRS carriers, except the presence of oral disease. Conclusions: The results underline the potential role of the oral cavity as a reservoir of staphylococci.     

Streptococcus cristatus ArcA interferes with Porphyromonas gingivalis pathogenicity in mice

Xie H, Hong J, Sharma A, Wang B‐Y. Streptococcus cristatus ArcA interferes with Porphyromonas gingivalis pathogenicity in mice. J Periodont Res 2012; 47: 578–583. © 2012 John Wiley & Sons A/S Background and Objective: Porphyromonas gingivalis has been implicated as one of the major pathogens in chronic periodontitis, an infectious disease affecting the majority of the adult population. We have previously demonstrated that a surface protein, arginine deiminase (ArcA), of Streptococcus cristatus represses production of P. gingivalis long fimbriae and interrupts the formation of P. gingivalis biofilms in vitro. Our in vivo studies have also shown that the distribution of P. gingivalis and S. cristatus in human subgingival plaque is negatively correlated. The objective of this study was to determine if S. cristatus ArcA inhibits P. gingivalis colonization and attenuates its subsequent pathogenesis in alveolar bone loss in the murine oral cavity. Material and Methods: A wild‐type strain of S. cristatus (CC5A) and its arcA knockout mutant (ArcAE) were used as initial colonizers in the oral cavity of BALB/cByJ mice. Colonization of P. gingivalis on the existing S. cristatus biofilms was assessed by quantitative PCR, and P. gingivalis‐induced alveolar bone loss was measured 6 wk after P. gingivalis infection. Results: The presence of S. cristatus CC5A, but not its arcA mutant, attenuated P. gingivalis colonization in the murine oral cavity. In addition, P. gingivalis‐induced alveolar bone loss was significantly lower in mice initially infected with S. cristatus CC5A than in those infected with the arcA mutant. Conclusion: This study provides direct evidence that S. cristatus ArcA has an inhibitory effect on P. gingivalis colonization, which may in turn attenuate the pathogenicity of P. gingivalis.     

Prevalence of oral methicillin-resistant Staphy/ococcus aureus in an institutionalized veterans population

Methicillin-resistant Staphylococcus aureus ( MRSA) is a nosocomial pathogen now of great concern in nursing homes and other institutional settings. MRSA has been well-documented to inhabit the nares, skin wounds, and respiratory tract, but little is known about its presence in the oral cavity. In this study, all patients admitted to an 80-bed VA extended care facility were cultured weekly for 12 weeks to detect the presence of MRSA in the nares, wounds, in-dwelling devices, and the oral cavity. Of a total of 107 participating subjects, 20 cultured positive for oral MRSA, yielding a prevalence of 18.7%, compared with 19.6% prevalence in the nares —the traditionally accepted screening site for MRSA. There was a 91.6% agreement between oral and nasal carriage in subjects, but four of 107 subjects (3.7%) cultured positive for oral MRSA without evidence of nasal carriage. These results suggest that oral MRSA may be more common than previously thought in high-risk settings, with a prevalence comparable with that of nasal infection. Further investigation is necessary to characterize the factors associated with the presence of MRSA in the oral cavity     

Association of asymptomatic oral candidal carriage, oral candidiasis and CD4 lymphocyte count in HIV-positive patients in China

OBJECTIVES: To compare the prevalence of asymptomatic oral candidal carriage in healthy volunteers with human immunodeficiency virus (HIV)-positive patients in China, as well as to investigate the relationship between CD4+ lymphocyte count and oral candidal colonization or oral candidiasis. METHODS: Oral candidal carriage and oral candidiasis were investigated in 101 patients with HIV-infection seen at Youan Hospital, Beijing, China. Two hundred and seventeen healthy volunteers were involved as a control. Culture from saliva was used to test for the presence of oral Candida. CD4+ lymphocyte count was measured by flow cytometry. All data were analyzed statistically by SAS. RESULTS: Asymptomatic oral candidal carriage rate (28.6%) in HIV-positive group was similar to that in the healthy group (18.0%; P = 0.07). No significant difference in CD4+ lymphocyte count was found between oral Candida carriers and non-carriers among HIV-positive subjects (P = 0.89). However, the frequency of oral candidiasis increased with the decrease in CD4+ lymphocyte count (P < 0.0001), and pseudomembranous candidiasis was predominant in HIV-positive patients with CD4+ <200 cells microl(-1) (66.7%). CONCLUSIONS: In HIV-positive subjects, asymptomatic oral candidal colonization is not related to CD4+ lymphocyte count of blood, and the carriage rate is similar to that in the healthy population. Oral candidiasis is more likely to be observed in HIV-positive patients who have a low CD4+ lymphocyte count.     

Changes in oral health over a 10-yr period in Switzerland

The Swiss Health Surveys are conducted every 5 yr, and alternate surveys contain information on oral health. Worldwide the population is ageing and oral health is improving. The aim of this study was to identify if these trends are continuing in a relatively affluent society with low levels of edentulousness. Participants in the 1992 and 2002 surveys completed a written questionnaire including items on oral health (response rates 75% and 86% respectively). Data were weighted and bivariate analyses were performed to calculate the average number of missing teeth and the prevalence of different prosthetic dental restorations for each cohort. Over the 10-yr period the proportion of subjects retaining all natural teeth increased, and the mean number of teeth increased, on average, by 1.3. Among those who required prosthetic dental restorations, fixed restorations increased and complete denture use was reduced. Strikingly, 4.4% of this sample reported having oral implants in 2002. Greater numbers of missing teeth and a higher prevalence of use of removable prostheses were still seen in women, in those who had only completed compulsory education, in subjects from families with low income, in those who smoke, and in those who were overweight, in 2002.     

The relationship between oral hygiene and oral colonization with Candida species in healthy adult subjects*

To cite this article:
Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2009.00371.x
Darwazeh AM‐G, Hammad MM, Al‐Jamaei AA. The relationship between oral hygiene and oral colonization with Candida species in healthy adult subjects. Abstract: Poor oral hygiene has been frequently suggested as a predisposing factor for oral candidal colonization, but the convincing evidence is lacking. Objective: To assess and compare oral candidal colonization, both quantitatively and qualitatively, in groups of healthy dentate subjects with different levels of oral hygiene as determined by the plaque index (PI) and gingival index (GI) scores. Methods: The concentrated oral rinse technique was used to isolate Candida species from 149 healthy dentate subjects. Candida species were cultured on Sabouraud’s dextrose agar plates and identified by germ‐tube test and the automated Vitek® system biochemical yeast card. According to the PI and GI scores, subjects were divided into different groups of oral hygiene level. Results: Candida species were isolated from 86 (57.7%) subjects. The prevalence of candidal carriage increased significantly as a function of age (P = 0.023), but was comparable between males and females (58.7% and 56.7% respectively; P = 0.87). Oral candidal carriage rate and density were not affected by the levels of dental plaque or gingival condition. The prevalence of oral candididal carriage was significantly higher in the subjects who were not using dental floss compared with those who were using dental floss (P = 0.032). Conclusion: Oral hygiene status, as determined by the PI and the GI scores per se, does not affect oral candidal colonization in healthy dentate subjects.     

Confounding and interaction effect of Treponema denticola salivary carriage in chronic periodontitis

Oral Diseases (2010) 16 , 278–285 Aim: To evaluate the salivary carriage of Treponema denticola and its association with demographic variables in the etiopathogenesis of chronic periodontitis. Subjects and methods: Ninety‐seven chronic periodontitis (CP) patients and a control group of 51 healthy subjects (HC) were selected. Periodontal status was assessed by criteria based on probing depth, attachment loss, extent, and severity of periodontal breakdown. A polymerase chain reaction method was used to determine the occurrence of T. denticola in saliva samples. Risk indicators for CP were assessed individually and adjusted for confounding and/or interaction using a logistic regression model. Results: Although univariate analysis revealed a positive association of age ≥30 years, smoking, and salivary carriage of T. denticola with CP, after logistic regression analysis, the association between age ≥30 years/smoking and CP persisted, whereas salivary carriage of T. denticola failed to achieve statistical significance. An interaction effect was significantly detected between these three variables. Conclusion: Although salivary carriage of T. denticola may be a risk indicator for CP, its pathogenicity should not be exclusively endorsed to its detection in saliva, but it might be associated with the synergistic biological interaction of the bacterium with some demographic characteristics of the susceptible host.     

Antibiotic susceptibility of Staphylococcus aureus isolates in oral mucosa and pockets of patients with gingivitis-periodontitis

Both oral cavity and subgingival pocket are ecological niches conducive to hosting microorganisms that may act as opportunistic pathogens, such as Staphylococcus aureus and especially methicillin-resistant Staphylococcus aureus (MRSA). Early detection of MRSA is a matter of concern to Public Health. The aim of our study was to determine phenotypic and genotypic detection of methicillin resistance of S. aureus in oral mucosa and subgingival pocket in 102 patients with gingivitis-periodontitis. The prevalence of S. aureus was 10.8% (n = 11) in subgingival pocket and 19.6% (n = 20) in oral mucosa. We obtained 31 isolates of S. aureus of which 13 were mecA positive and 18 were mecA negative. Detection of mecA gene by PCR was used as the reference method to compare the results of phenotypic methods to determine methicillin resistance. Early, accurate detection of S. aureus through phenotyping and genotyping methods is crucial for assessing the colonization and preventing the spread of MRSA.     

Oral Candida carriage,quantification, and species characterization in oral submucous fibrosis patients and healthy individuals

Aim: To determine the prevalence of oral Candida carriage, candidal quantification, and various subtypes of Candida species in oral submucous fibrosis patients and healthy individuals. Methods: The study comprised 30 clinically‐diagnosed and ‐staged oral submucous fibrosis patients aged 20–40 years, and 20 age‐ and sex‐matched controls. Buccal mucosa was sampled by sterile swab technique. Each sample was inoculated on Sabouraud’s dextrose agar and CHROMagar culture media. Candida species identification was done using the KB006 Candida identification kit. Results: Eleven (36.67%) cases in the study group, and two (10%) cases in the control group, yielded Candida on culture. The value of CFU/mL increased with an increased duration of betel quid chewing habit. All Candida‐positive oral submucous fibrosis patients complained of a burning sensation. Candida albicans and Candida tropicalis were the most common species in the oral submucous fibrosis cases. Candida dubliniensis was isolated in both the study and control groups. Conclusions: Our observations in this study affirm that oral submucous fibrosis favors the colonization of Candida. Mucosal alterations due to the underlying disease process or betel quid chewing, coupled with other factors, might lead to candidal colonization, even in the absence of clinically‐related mycotic manifestations.     

Oral health promotion interventions on oral reservoirs of staphylococcus aureus: a systematic review

The oral cavity serves as a reservoir of Staphylococcus aureus for infection of the lower respiratory tract and cross-infection to other patients. This systematic review was designed to examine the effectiveness of oral health promotion interventions on this pathogen. The PubMed, ISI Web of Science, and Cochrane Library databases were searched for clinical trials assessing the effect of oral health promotion interventions on oral and oropharyngeal carriage of S. aureus. Oral health promotion interventions on oral reservoirs of S. aureus in both systemically healthy and medically compromised groups consisted of oral hygiene interventions only. There was a lack of evidence pertaining to the effectiveness of mechanical oral hygiene interventions against this pathogen. Chlorhexidine delivered in oral hygiene products such as mouthrinses, gels, and sprays appeared to have some utility against S. aureus, although some studies found equivocal effects. There was a dearth of studies investigating the efficacy of other chemical agents. Although many chemical agents contained in oral hygiene products have proven in vitro activity against S. aureus, their clinical effectiveness and potential role as adjuncts or alternative therapies to conventional treatment remain to be confirmed by further high-quality randomized controlled trials.     

Natural defenses against Candida colonization breakdown in the oral cavities of the elderly.

Candida colonization of the oral cavity increases in the elderly. A major predisposing condition is denture use, which also increases in the elderly. To test whether the increase in colonization is age-related in a fashion independent of denture use, we analyzed the frequency (incidence) of carriage, the intensity of carriage, the multiplicity of species, and the genetic relatedness of strains in the oral cavities of 93 test subjects separated into the three age groups: 60 to 69 yr, 70 to 79 yr, and > or = 80 yr. Each age group was further subdivided into subjects with and without dentures, and into males and females. The results demonstrate that the frequency of carriage, the intensity of carriage, and multispecies carriage all increase as a function of age and differ according to gender, in both cases independent of denture use, suggesting that the natural suppression of yeast carriage in the oral cavity breaks down in the elderly. In addition, it is demonstrated that Candida glabrata colonizes the oral cavities of elderly individuals without dentures only after 80 yr of age, suggesting that there are age-related compromising conditions other than denture use in this most elderly age group.     

Salivary proteins promote proteolytic activity in Streptococcus mitis biovar 2 and Streptococcus mutans

A major function of the salivary pellicle on oral surfaces is to promote colonization of the commensal microbiota by providing binding sites for adherence. Streptococcus mitis is an early colonizer of the oral cavity whereas Streptococcus mutans represents a later colonizer. To survive and grow, oral bacteria produce enzymes, proteases and glycosidases, which allow them to exploit salivary proteins as a nutrient source. In this study, adherence and proteolytic activity of S. mitis biovar 2 and S. mutans were investigated in a flow‐cell model in the presence of different populations of surface‐associated salivary proteins. Streptococcus mitis biovar 2 adhered well to surfaces coated with both a MUC5B‐enriched fraction and a pool of low‐density proteins containing MUC7, amylase, cystatin, gp340, immunoglobulin A, lactoferrin, lysozyme and statherin, whereas adherence of S. mutans to these proteins was poor. In environments of MUC5B or the low‐density proteins, both S. mitis biovar 2 and S. mutans showed high levels of proteolytic activity. For S. mitis in the MUC5B environment, most of this activity may be attributable to contact with the molecules in the fluid phase although activity was also enhanced by adherence to surface‐associated MUC5B. These data suggest that although they differ in their capacity to adhere to surface‐associated salivary proteins, in the natural environment exploitation of saliva as a nutrient source can contribute to survival and colonization of the oral cavity by both S. mitis biovar 2 and S. mutans.     

Molecular mechanisms of Staphylococcus aureus nasopharyngeal colonization

Staphylococcus aureus is responsible for a wide range of different infections ranging in severity from mild to fatal. However, it primarily exists as a commensal organism in a number of different anatomical sites including the nasopharynx. Although colonization itself is a harmless state, colonized individuals are at risk of endogenous infection when S. aureus enters otherwise sterile sites via wounds or indwelling medical devices. As such, studies of colonization may identify important targets for vaccines or other prophylactic approaches. Colonization is a dynamic process; S. aureus must attach to host surfaces, overcome immune components and compete with other commensal microbes. This occurs via a number of surface-attached and secreted proteins and other factors such as wall teichoic acid. In addition, colonizing S. aureus must constantly replicate to maintain its niche and exclude other strains. These myriad interactions provide a strong selective pressure for the maintenance or enhancement of mechanisms of adhesion, invasion and immune evasion. The evolutionary implications of this may explain why S. aureus is such a capable pathogen because many of the proteins involved in colonization have also been identified as virulence factors. This review describes the diverse molecular mechanisms used by S. aureus to colonize the host and discusses how the pressures that have selected for these may have led to its virulence.     

Relationship between oral motor dysfunction and oral bacteria in bedridden elderly

OBJECTIVE: The purpose of this study was to analyze the relationship between oral bacterial colonization and oral motor dysfunction. STUDY DESIGN: Oral motor dysfunction (swallowing and speech disorders) and detection of oral bacterial species from dental plaque in 55 elderly persons who had remained hospitalized for more than 3 months were investigated and statistically analyzed. RESULTS: The detection rates of methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Streptococcus agalactiae, and Stenotrophomonas maltophilia were significantly higher in subjects with than in those without a swallowing disorder. A similar result was found with regard to the presence of a speech disorder. About half of subjects who had oral motor dysfunction and hypoalbuminemia had colonization by MRSA and/or Pseudomonas aeruginosa. CONCLUSION: These results suggest that the combination of oral motor dysfunction and hypoalbminemia elevated the risk of opportunistic microorganisms colonization in the oral cavity of elderly patients hospitalized over the long term.     

Asymptomatic oral Candida albicans carriage in HIV-infection: frequency and predisposing factors

Many studies have focused on the epidemiology and pathogenesis of oral candidiasis in HIV infection. Little is known on the incidence and predisposing factors of asymptomatic oral Candida carriage in this setting, obviously an important issue in view of prophylaxis. To address this question. 261 consecutive HIV-infected individuals without clinical evidence of candidiasis were investigated. C. albicans was isolated from cultured oral cavity swabs of 63 subjects (24%). Colonization was significantly more frequent in IV drug users. CDC groups IV. and in subjects with lymphocytopenia. CD4+ cell depletion, or elevated beta-2 microglobulin. These data further suggest that oral candidiasis occurs in HIV infection as a result of C. albicans overgrowth and raise the question of primary antifungal prophylaxis in subjects with low CD4 counts and asymptomatic oral Candida carriage.     

Prevalence of human papillomaviruses in the healthy oral mucosa of women with high‐grade squamous intra‐epithelial lesion and of their partners as compared to healthy controls

Oral human papillomavirus (HPV) carriage rates were investigated in relation to genital HPV carriage in women with HPV‐associated cervical lesions and male partner of such women, including several couples, in comparison with healthy individuals. Buccal and lingual mucosa of 60 males and 149 females with healthy oral mucosa and without known genital lesion, genital and oral mucosa of further 40 females with cervical high‐grade squamous intraepithelial lesion (HSIL) and 34 male sexual partners of women with HSIL (including 20 couples) were sampled. HPV DNA was detected using MY/GP PCR. Genotype was determined by sequencing or restriction fragment length polymorphism. Virus copy numbers were determined by real‐time PCR. Overall, oral HPV carriage rate was 5.7% (12/209) in healthy individuals; average copy number was 5.8 × 10² copies/1 μg DNA; male and female rates were comparable. Oral carriage in women with HSIL was significantly higher, 20.0% (8/40, P = 0.003); males with partners with HSIL showed a carriage rate of 17.6% (6/34), copy numbers were similar to the healthy controls. In contrast, genital carriage rate (52.9%, 18/34 vs. 82.5%, 33/40; P = 0.006) and average copy number were lower in males (5.0 × 10⁵ vs. 7.8 × 10⁵ copies/1 μg DNA; P = 0.01). Oral copy numbers in these groups and in healthy individuals were comparable. High‐risk genotypes were dominant; couples usually had the same genotype in the genital sample. In conclusion, genital HPV carriage is a risk factor of oral carriage for the individual or for the sexual partner, but alone is not sufficient to produce an oral HPV infection in most cases.     

Prevalence of fimA genotypes of Porphyromonas gingivalis and periodontal health status in Chinese adults

Background and Objective:  Porphyromonas gingivalis fimbriae play a key role in colonization of the oral cavity. The fimA gene, which encodes fimbrillin ( FimA ), can be classified into six types (I–V and Ib) according to nucleotide sequence. In the present study, we investigated the relationship between the prevalence of P. gingivalis -specific fimA genotypes and periodontal health status in Chinese adults.
Material and Methods:  One-hundred and fifteen patients with chronic periodontitis and 136 periodontally healthy adults were selected. P. gingivalis detection, determination of fimA genotypes, and the co-existence of Actinobacillus actinomycetemcomitans and Tannerella forsythia with various fimA types, were assessed by the polymerase chain reaction. Odds ratios and 95% confidence intervals were calculated for associating the fimA -specific genes with periodontitis.
Results:  P. gingivalis was detected in 22.1% of healthy subjects and in 81.7% of the patients. A single fimA genotype was detected in most samples. In healthy adults, the most prevalent fimA genotype was type I (66.7%). However, type II was detected most frequently (43.6%) in the patient group, followed by type IV (30.9%). The frequency of co-existing A. actinomycetemcomitans and T. forsythia was highest in type II fimA -positive sites. Statistical analysis revealed that periodontitis was associated with occurrences of type I (odds ratio 0.97), Ib (odds ratio 13.26), II (odds ratio 36.62), III (odds ratio 4.57), IV (odds ratio 22.86) and V (odds ratio 1.19).
Conclusion:  P. gingivalis type II followed by type IV were considered as disease-associated strains that account for the pathogenesis of chronic periodontitis in Chinese adults.     

Detection of Helicobacter pylori by polymerase chain reaction in the subgingival biofilm and saliva of non-dyspeptic periodontal patients

BACKGROUND: Helicobacter pylori has been associated with the development of peptic ulcers and gastric cancer. Although the oral cavity may be a source of transmission, it is unknown whether it acts as a permanent reservoir for this bacterium, particularly in the presence of periodontal disease. The purpose of this study was to evaluate the prevalence of H. pylori by polymerase chain reaction (PCR) in the subgingival biofilm and saliva of subjects with periodontitis. METHODS: Samples were obtained from 56 periodontally healthy subjects and 169 subjects with chronic periodontitis. DNA was extracted from the samples, and the detection of H. pylori was carried out by PCR using the JW22/23 primers. RESULTS: In general, H. pylori was detected in 24% of all samples evaluated. A significantly higher prevalence of H. pylori was observed in subgingival biofilm samples (33.3%) compared to saliva samples (20%) (P <0.05). H. pylori was detected significantly more often in the saliva and subgingival samples from subjects with periodontitis (23.5% and 50%, respectively) compared to samples from periodontally healthy subjects (7.3% and 11.4%, respectively; P <0.05). CONCLUSION: H. pylori was detected frequently in the oral microbiota of subjects with periodontitis, suggesting that periodontal pocketing and inflammation may favor the colonization by this species.     

Streptococcus mitis: walking the line between commensalism and pathogenesis

Streptococcus mitis is a viridans streptococcus and a normal commensal of the human oropharynx. However, S. mitis can escape from this niche and cause a variety of infectious complications including infective endocarditis, bacteraemia and septicaemia. It uses a variety of strategies to effectively colonize the human oropharynx. These include expression of adhesins, immunoglobulin A proteases and toxins, and modulation of the host immune system. These various colonization factors allow S. mitis to compete for space and nutrients in the face of its more pathogenic oropharyngeal microbial neighbours. However, it is likely that in vulnerable immune‐compromised patients S. mitis will use the same colonization and immune modulation factors as virulence factors promoting its opportunistic pathogenesis. The recent publication of a complete genome sequence for S. mitis strain B6 will allow researchers to thoroughly investigate which genes are involved in S. mitis host colonization and pathogenesis. Moreover, it will help to give insight into where S. mitis fits in the complicated oral microbiome. This review will discuss the current knowledge of S. mitis factors involved in host colonization, their potential role in virulence and what needs to be done to fully understand how a an oral commensal successfully transitions to a virulent pathogen.     

A novel p.S34N mutation of CAMP gene in patients with periodontal disease

Objective

Recent studies have showed that genetic factors involved in the host responses might determine the severity of periodontitis. hCAP-18/LL-37 is a part of the innate immune response in the oral cavity. The aim of the present study was to investigate the mutation of CAMP gene encoding hCAP-18/LL-37 in the patients with different periodontal diseases.

Design

Seventy-eight chronic periodontitis, 72 generalized aggressive periodontitis, and 149 controls were analysed for mutation of CAMP gene using direct DNA sequencing method. Frequencies of p.S34N mutation were compared by Pearson chi-square test. Logistic regression analysis was used to analyse the association between periodontitis and p.S34N mutation adjusting for bleeding on probing, age and gender.

Results

Twenty-five subjects had a novel missense mutation of CAMP gene. Single base substitution (c.101G>A) in exon 1 led to p.S34N mutation. All amino acid substitutions were heterozygous mutation. The patients with generalized aggressive periodontitis had significantly higher p.S34N mutation prevalence compared to the others, whilst there was no significant difference in prevalence of p.S34N mutation between the patients with chronic periodontitis and the control subjects. Logistic regression analysis adjusted for BOP, age and gender revealed that the patients with generalized aggressive periodontitis were 5.32 times more likely to have p.S34N mutation compared to the controls (OR = 5.32, 95% CI: 1.3–22.1).

Conclusion

We report a novel missense mutation of CAMP gene. p.S34N mutation in CAMP gene seems to be contributing factor for generalized aggressive periodontitis, but not for chronic periodontitis.