Key role for Fusobacterium adhesin in non-orthodontic periodontal inflammation

Researchers from China have found that patients with gingivitis and periodontitis are more likely to have Fusobacterium nucleatum carrying the novel Fusobacterium adhesin A (fadA) than periodontally healthy people.

The results suggest that fadA, which is required for entry of the bacterium into endothelial cells, plays an important role in the development of gingivitis in patients without orthodontic devices.

Shuiqing Xiao (Jinan Stomatological Hospital) and colleagues studied 55 patients with gingival inflammation during orthodontic treatment (orthodontic group), 30 periodontally healthy people (control group), 49 gingivitis patients without orthodontic treatment (non-orthodontic gingivitis group), and 35 periodontitis patients (periodontitis group).

F. nucleatum was detected in subgingival biofilm samples in 69.1% of the orthodontic group, compared with 46.7% of the control group, a significant difference. Meanwhile, rates in the non-orthodontic gingivitis group and periodontitis group were even higher at 83.7% and 82.9%, respectively. The respective rates of fadA positivity were 58.2%, 33.3%, 69.4%, and 71.4%.

Additionally, the team showed that the prevalence of F. nucleatum and fadA increased with gingival index (GI) value. For example at level 0 of GI, F. nucleatum prevalence was 50% compared with 81% in level 2, while rates of fadA were 35%, and 74%, respectively.

They found a significant correlation between GI and prevalence of F nucleatum/fadA. However, this association was not significant in the orthodontic group, and, compared with the control group, the prevalence of F. nucleatum/fadA was significantly higher only in patients with a GI of 2 from the periodontitis group and non-orthodontic gingivitis group.

Writing in PLoS One, Xiao et al say the results show that “… F. nucleatum carrying fadA is one of the potential risks that are responsible for non-orthodontic periodontal inflammation.”

They conclude: “All orthodontic patients must receive oral hygiene instruction and professional prophylaxis to maintain gingival health. Moreover, further research is needed to verify the periodontal potential health risks and to find the most effective way of controlling periodontal pathogenic anaerobic bacteria during orthodontic treatment.”

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