Discussion
periodontium, gingivitis
PERIODONTAL DISEASE, DISEASE, GINGIVITIS, DISEASE CHARACTERISTIC
Periodontal disease, an inflammatory destructive disease of the periodontium caused by a disbyotic microbial community, is associated with specific presence and abundance of bacteria in the subgingival biofilm, namely those belonging to the so-called red complex, including Bacterial clusters associated with periodontal health, gingivitis, and periodontal diseaseBased on these premises, our study aimed to define the modulation of the periodontal microbiome in response to subgingival ultrasonic debridement with or without the adjunctive use of air-polishing with erythritol powder + chlorhexidine. This is the second part of a study previously published by the same research group, reporting the clinical outcomes of the proposed treatments[Willing to compare the amount of specific periodontitis-related and health-related bacteria before and after treatment, the microbiological profile of the periodontal niche was analyzed by qPCR microarray, allowing to quantitate the individual potential periodontopathogens, contrary to what could be obtained by 16S rRNA sequencing technique, which only provide relative abundance data.The analysis at baseline (T0) showed, as expected, a high prevalence and amount of known and putative periodontal bacteria in the subgingival microbiome of the enrolled subjects: besides the classical periodontopathogens, including the genera Statistically significant modulations were mostly observed in test group, rather than control group, suggesting the ability of erythritol + chlorhexidine powder treatment to influence more deeply the recovery of a healthy periodontal microbiome. Chlorhexidine is a well-known antimicrobial, and erythritol seems to be able to suppress the growth of Absence of disease does not only involve the reduction of pathogenic bacteria, but also the re-establishment of a healthy microbiota[To assess the possible impact of the different epidemiological or disease characteristics of the enrolled subjects on the response to treatment and consequent microbiome remodulation, we stratified the results accordingly to such features and analyzed the microbial significance separately. The enrolled subjects were thus stratified according to gender, smoking habit, and sampling performed in single-rooted or multi-rooted teeth, periodontal pockets greater or less than 8 mm of depth, and distal or medial tooth sites. The collected data showed that female gender and non-smokers could get better response in terms of microbial remodulation of the periodontal profile, compared to males and smokers. While the immunosuppressive nature of tobacco is well known[