IDDF2024-ABS-0372 The role of the oral-gut microbiome axis in connecting periodontitis with gastrointestinal and systemic diseases

Background Periodontitis is characterized by oral bacterial dysbiosis causing persistent inflammation in dental supporting tissue, leading to tissue breakdown and bone loss. The colonization of periodontal pathogens in the gastrointestinal tract has contributed to inflammatory gastrointestinal disease pathogenesis. This research aims to investigate changes in the gut microbiome caused by periodontitis and their association with the development of gastrointestinal and systemic diseases. Methods A systematic literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline across four databases (Ovid MEDLINE, ProQuest, Scopus, and Pubmed; dated to 30th April 2024). The research was conducted using the search string: ('gut microbiome') AND ('periodontitis' OR 'periodontal disease'). Studies reporting on the relationship between the gut microbiome, periodontitis and associated gastrointestinal and systemic diseases were included. Results There were 43 of 402 studies fulfilling the inclusion criteria selected for qualitative analysis. Thirty studies profiled the gut microbiota in humans and animals with periodontitis, while others explored the bidirectional regulation of periodontal and gut microbiota and potential mechanisms causing other diseases. The main findings demonstrated that periodontal pathogens can induce changes in the gut microbiome composition, leading to dysfunction of the intestinal barrier and intestinal immune imbalance, thus exacerbating inflammatory responses of other organs (e.g., hypertension, liver disease, Parkinson's disease, neurosis) (IDDF2024-ABS-0372 Figure 1). Periodontitis patients present a less diverse gut microbiome consistent with other systemic inflammatory diseases. Periodontitis and gastrointestinal diseases are bidirectionally regulated by changes in microbiota through the oral-gut axis. Anaerobic periodontal bacteria like Fusobacterium, Parvimonas, Peptostreptococcus, Porphyromonas, and Prevotella were found in feces/tissue samples. Certain gut microbiota taxa like Prevotella 7, Lachnospiraceae UCG-008, Pasteurellales, and Enterobacteriaceae were implicated in increasing the risk of periodontitis. Fusobacterium has been confirmed by many scholars as a key bacterium in the oral-gut axis. Conclusions A potential connection can be drawn between gut dysbiosis and periodontitis, possibly mediated via the translation of periodontal pathogens from periodontal tissues to the intestine, further disrupting the balance of the gut microbiome and triggering the development of other diseases. These findings pave the way for the future development of novel diagnostic and therapeutic interventions for periodontitis-related gastrointestinal/systemic diseases.