The role of mycoplasmas in oro-dental diseases

This study aimed to isolate mycoplasmas from oral cavity of patients with oro-dental diseases, to evaluate their role in pathogenesis of these diseases, and to evaluate the effects of some antibiotics on them. The population enrolled in this study was individuals attending the dental out-patient clinics in the dental specialty center in Basrah, from private dental clinic, and from otolaryngology out–patient clinic. It consisted of 154 patients with periodontal diseases (gingival diseases & periodontal abscesses) and oral ulcers of different types, in addition to that, 50 healthy subjects were included as control group. It included 112 males and 92 females, their age ranged from 6 to 68 years. This study extended from the period between August 2010 to December 2011. Samples from gingival sulcus or periodontal spaces were obtained by using paper points and swabs from ulcer surface, all specimens were cultured within one hours of sampling. For the isolation of mycoplasma, each specimen was directly inoculated into the liquid phase of MDCS. Mycoplasma spp. were isolated from 120 individuals out of 204 enrolled in this study, males affected more than females, the commonly affected age group was 20-29 years. Smoking play a clear role in causation of dental diseases and mycoplasma found more in smoker patients, (62 were smokers, 36 were non-smokers).Gingival diseases were commonly presented (62 patients), followed by inflammatory oral ulcers (45 patients). Mycoplasma salivarium was the frequently isolated species (70.8%), followed by mycoplasma orale (isolated from 16.6%). Single mycoplasma infection was found in 4 cases, 3 in gingival diseases which were 2 mycoplasma salivarium and one M.orale. The last spp. was M. pneumoniae, it was isolated from periodontal abscess. Tertracycline and erythromycin showed good inhibitory effects against mycoplasmas. In conclusion, Mycoplasma isolated from males with oro dental diseases more than females. The mostly affected age group was 20-29 years of age. Mycoplasma salivarium was the commonest isolated species, followed by mycoplasma orale. It is rare to find single mycoplasma infection in the oral cavity, just 4 cases were documented from total 98 patients. Tetracycline and erythromycin can significantly inhibit the growth of mycoplasma. Introduction ycoplasma refers to a genus of Gramnegative bacteria that lack a cell wall 1 . Without a cell wall, they are unaffected by many common antibiotics such as penicillin or other beta-lactam antibiotics that target cell wall synthesis. They can be parasitic or saprotrophic. Several species are pathogenic in humans, including M.pneumoniae, which is an important cause of atypical pneumonia and other respiratory disorders, and M.genitalium, which is believed to be involved in pelvic inflammatory diseases. Microorganisms from the oral cavity have been shown to cause a number of oral infectious diseases, including caries (tooth decay), periodontitis (gum disease), endodontic (root canal) infections, alveolar osteitis (dry socket), and tonsillitis. Mouth ulcer is a very common oral lesion. Epidemiological studies show an average prevalence between 15% and 30%. Trauma M The role of mycoplasmas in oro-dental diseases Zahra K Saeed & Ghaeda J Al-Ghizawi Bas J Surg, December, 20, 2014 24 to the mouth is a common cause of ulcers 2 . Infection whether viral, fungal and bacterial play a major role in causation of oral ulcers. Many researchers view the causes of aphthous ulcers as a common end product of many different disease processes, each of which is mediated by the immune system 3 . Materials and methods The population enrolled in this study was individuals attending the dental out-patient clinics in the dental specialty center in Basrah, from private dental clinic, and from otolaryngology outpatient clinic. The sample obtained consisted of 154 patients with periodontal diseases (gingival diseases and periodontal abscesses) and oral ulcers of different types, in addition to that, 50 healthy subjects included as control group. It included 112 males and 92 females, their age ranged from 6 to 68 years. This study extended from the period between August 2010 to December 2011. A special questionnaire forma was prepared and filled by same researcher. Samples from gingival sulcus or periodontal spaces were obtained by using paper points. Dentist selects localizations of interest and remove supragingival plaque from dental surface with a cotton. Then, insert a sterile size 45 paper point into the gingival sulcus or periodontal pocket, also swabs taken from ulcers surface, regarding control group the swabs taken from their saliva. All specimens were cultured within one hours of sampling. For the isolation of mycoplasma, each specimen was directly inoculated into the liquid phase of Monophasic diphasic culture setup (MDCS), Mixed up well and tilted for a while, once or twice, to cover the upper slanted portion in (MDCS) prior to inoculation 4 . For the isolation of bacteria other than mycoplasmas, another 2 swabs from same lesions were obtained from same patients and control, then, each specimen after being transported to the laboratory was directly cultured into MacConkey and blood agar by the streaking method then incubation done. Results Table I shows 120 positive mycoplasma cultures in both patients and control group (comprises 58.8%), this divided into 98 positive cultures in patient group and 22 in control group, while 84 individuals in this study, had negative mycoplasma culture from which 56 were real patients and 28 subjects from the control group, these results are not statistically significant, (P> 0.05, X 2 =3.322). Table I :Mycoplasma culture results in patient and control groups. Total Controls Patients Culture results 120(58.8%) 22 (44%) 98 (63.6%) Mycoplasma +ve cultures 84 (41.2%) 28 (56%) 56 (36.4%) Mycoplasma –ve cultures