title: Microbial Profiling in Experimentally Induced Biofilm Overgrowth Among Patients With Various Periodontal States.
abstract: BACKGROUND
  This study measures microbial composition changes during biofilm overgrowth and subsequent removal among patients with various states of periodontal disease.
  
  
  METHODS
  In this prospective cohort study, 175 participants with various periodontal states (five biofilm-gingival interface [BGI] groups) abstained from oral hygiene while using an acrylic stent. At day 21, participants reinstituted oral hygiene and were followed for 4 weeks. Clinical parameters were recorded, and subgingival plaque samples were analyzed at baseline, peak of induction (day 21), and resolution using 16S rRNA probes (human oral microbe identification microarray [HOMIM]). Using the change score (peak at induction minus baseline) for bleeding on probing and probing depth (PD), the patients were separated into high and low clinical responders.
  
  
  RESULTS
  At baseline, synergistetes were more abundant in moderate and severe periodontitis (BGI-P2 and -P3) compared to mild periodontitis (BGI-P1), health (BGI-H), and gingivitis (BGI-G) (P = 0.005). Overall, at day 21 there was an increase in HOMIM scores of firmicutes (P ≤0.001), fusobacteria (P = 0.003), proteobacteria (P ≤0.001), synergistetes (P = 0.04), and bacteroidetes (P ≤0.001). At resolution, these phyla returned to baseline, except for synergistetes. Levels of synergistetes were significantly higher at day 21 (P ≤0.0001) and resolution (P = 0.0002) for high clinical responders compared to low responders.
  
  
  CONCLUSIONS
  The association of synergistetes as a baseline predictor of incident PD increase, as well as the higher levels at day 21, indicates a pathogenic role for these organisms in disease progression in addition to the previously characterized fusobacteria, proteobacteria, firmicutes, and bacteroidetes.
authors.affiliation: Periodontology Department, School of Dental Medicine, Case Western Reserve University, Cleveland, OH.
authors.forename: Andre
authors.initials: A
authors.lastname: Paes Batista da Silva
authors.affiliation: Periodontology Department, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC.
authors.forename: Silvana P
authors.initials: SP
authors.lastname: Barros
authors.affiliation: Periodontology Department, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC.
authors.forename: Kevin
authors.initials: K
authors.lastname: Moss
authors.affiliation: Biostatistics Department, University of North Carolina-Chapel Hill.
authors.forename: John
authors.initials: J
authors.lastname: Preisser
authors.affiliation: Periodontology Department, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC.
authors.forename: Julie T
authors.initials: JT
authors.lastname: Marchesan
authors.affiliation: Philips Oral Healthcare, Dental and Scientific Affairs, Bothell, WA.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Ward
authors.affiliation: Periodontology Department, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC.
authors.forename: Steven
authors.initials: S
authors.lastname: Offenbacher
mesh_terms: D018441:Biofilms; D003773:Dental Plaque; D006801:Humans; D010512:Periodontal Index; D010514:Periodontal Pocket; D010518:Periodontitis; D011446:Prospective Studies; D012336:RNA, Ribosomal, 16S
chemical_list: D012336:RNA, Ribosomal, 16S
keywords: Biofilms; disease progression; oral hygiene; periodontal diseases; stents