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      Microbiome in oral and maxillofacial surgery

      editorial
      , D.D.S., M.S.D., Ph.D.
      Journal of the Korean Association of Oral and Maxillofacial Surgeons
      The Korean Association of Oral and Maxillofacial Surgeons

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          Abstract

          Since Koch has reported the microorganisms are causes of infections, oral bacteria have been considered to be responsible for oral diseases such as periodontitis and dental caries. The oral cavity is the beginning of the digestive system and consists of various structures that are different from other digestive systems. Teeth are in oral cavity and there are periodontal ligaments and alveolar bone around teeth, covered by mucosa and masticatory mucosa which are keratinized epithelium. Tongue is specialized mucosa in oral cavity. Even the plaque, also known as the bacterial colony, has a very different environment depending on the supragingival and subgingival regions. Because of these various characteristics, microbiome in the oral cavity can be seen in various ways. Microorganisms living in the human body are called microbiota. The resident microorganism is known to be more abundant than the human body. Microbiome is the genome of this microbial organism. Microbiomes have been discussed in many recent studies due to the development of genomic and gene expression analysis. Terminal restriction fragment length polymorphism (T-RFLP) method uses restriction enzymes to digest the amplicons from the 16S rRNA gene which are introduced into the oral microbiome1. Oral bacteria are known to have more than 700 bacterial species. Chen et al.2 reported the results of the experiment which isolated and organized bacteria in the digestive organ including oral bacteria, using 16S rRNA gene-based methods. The goal of creating the expanded Human Oral Microbiome Database (eHOMD) is to provide the scientific community. Currently, eHOMD includes a total of 772 microbial species and links sequence data with phenotypic, phylogenetic, clinical and bibliographic information. All of the bacteria in the oral cavity are not related to diseases, but the site-specific bacteria are thought to be useful for identification and treatment of diseases. There are many studies for oral microbiome. A comparative study of Japanese and Korean patients could be also used for treatment and prophylactic purposes, as oral microbiomes have different compositions, which may affect periodontitis3. Schmidt et al.4 studied that the microbiome may provide a framework for monitoring oral cancer development, progression and recurrence. Liu et al.5 reported that the risk of post-operative inflammation at grafted sites might be related to the oral microbiota profile before alveolar bone grafting. Also, Pushalkar et al.6 suggested that colonization of unique bacterial communities coupled with deficient innate immune response is likely to impact the pathogenesis of osteonecrosis of the jaw. It would be good for oral and maxillofacial surgeons to research microbiomes associated with all diseases occurring in the oral and maxillofacial region. I hope to see more papers related to microbiome in the future.

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          Most cited references4

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          Changes in Abundance of Oral Microbiota Associated with Oral Cancer

          Individual bacteria and shifts in the composition of the microbiome have been associated with human diseases including cancer. To investigate changes in the microbiome associated with oral cancers, we profiled cancers and anatomically matched contralateral normal tissue from the same patient by sequencing 16S rDNA hypervariable region amplicons. In cancer samples from both a discovery and a subsequent confirmation cohort, abundance of Firmicutes (especially Streptococcus) and Actinobacteria (especially Rothia) was significantly decreased relative to contralateral normal samples from the same patient. Significant decreases in abundance of these phyla were observed for pre-cancers, but not when comparing samples from contralateral sites (tongue and floor of mouth) from healthy individuals. Weighted UniFrac principal coordinates analysis based on 12 taxa separated most cancers from other samples with greatest separation of node positive cases. These studies begin to develop a framework for exploiting the oral microbiome for monitoring oral cancer development, progression and recurrence.
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            Distinct composition of the oral indigenous microbiota in South Korean and Japanese adults

            A comparison of national surveys on oral health suggested that the population of South Korea has a better periodontal health status than that of Japan, despite their similar inherent backgrounds. Here, we investigated differences in oral bacterial assemblages between individuals from those two countries. To exclude potential effects of oral health condition on the microbiota, we selected 52 Korean and 88 Japanese orally healthy adults (aged 40–79 years) from the participants of two cohort studies, the Yangpyeong study in South Korea and the Hisayama study in Japan, and compared the salivary microbiomes. The microbiota of the Japanese individuals comprised a more diverse community, with greater proportions of 17 bacterial genera, including Veillonella, Prevotella, and Fusobacterium, compared to the microbiota of the Korean individuals. Conversely, Neisseria and Haemophilus species were present in much lower proportions in the microbiota of the Japanese individuals than the Korean individuals. Because higher proportions of Prevotella and Veillonella and lower proportions of Neisseria and Haemophilus in the salivary microbiome were implicated in periodontitis, the results of this study suggest that the greater proportion of dysbiotic oral microbiota in the Japanese individuals is associated with their higher susceptibility to periodontitis compared to the Korean individuals.
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              Oral microbiota and host innate immune response in bisphosphonate-related osteonecrosis of the jaw

              Bacterial biofilms have emerged as potential critical triggers in the pathogenesis of bisphosphonate (BP)-related osteonecrosis of the jaw (ONJ) or BRONJ. BRONJ lesions have shown to be heavily colonized by oral bacteria, most of these difficult to cultivate and presents many clinical challenges. The purpose of this study was to characterize the bacterial diversity in BRONJ lesions and to determine host immune response. We examined tissue specimens from three cohorts (n=30); patients with periodontal disease without a history of BP therapy (Control, n=10), patients with periodontal disease having history of BP therapy but without ONJ (BP, n=5) and patients with BRONJ (BRONJ, n=15). Denaturing gradient gel electrophoresis of polymerase chain reaction (PCR)-amplified 16S rRNA gene fragments revealed less bacterial diversity in BRONJ than BP and Control cohorts. Sequence analysis detected six phyla with predominant affiliation to Firmicutes in BRONJ (71.6%), BP (70.3%) and Control (59.1%). Significant differences (P<0.05) in genera were observed, between Control/BP, Control/BRONJ and BP/BRONJ cohorts. Enzyme-linked immunosorbent assay (ELISA) results indicated that the levels of myeloperoxidase were significantly lower, whereas interleukin-6 and tumor necrosis factor-alpha levels were moderately elevated in BRONJ patients as compared to Controls. PCR array showed significant changes in BRONJ patients with downregulation of host genes, such as nucleotide-binding oligomerization domain containing protein 2, and cathepsin G, the key modulators for antibacterial response and upregulation of secretory leukocyte protease inhibitor, proteinase 3 and conserved helix–loop–helix ubiquitous kinase. The results suggest that colonization of unique bacterial communities coupled with deficient innate immune response is likely to impact the pathogenesis of ONJ.
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                Author and article information

                Contributors
                Role: Associate Editor of JKAOMS
                Journal
                J Korean Assoc Oral Maxillofac Surg
                J Korean Assoc Oral Maxillofac Surg
                JKAOMS
                Journal of the Korean Association of Oral and Maxillofacial Surgeons
                The Korean Association of Oral and Maxillofacial Surgeons
                2234-7550
                2234-5930
                April 2018
                25 April 2018
                : 44
                : 2
                : 41-42
                Affiliations
                Department of Dentistry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
                Author notes
                Corresponding author: Won Lee. Dental Clinic, Uijeongbu St. Mary's Hospital, 271 Cheonbo-ro, Uijeongbu 11765, Korea. TEL: +82-31-820-3574, FAX: +82-31-847-2894, cmfs21@ 123456catholic.ac.kr
                Author information
                https://orcid.org/0000-0002-6383-8754
                Article
                10.5125/jkaoms.2018.44.2.41
                5932269
                29732307
                0c97fdb4-609e-4717-809c-fac67a830dd4
                Copyright © 2018 The Korean Association of Oral and Maxillofacial Surgeons.

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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