Oral resistome profiling in periodontal health and disease using next-generation sequencing

Objectives: This review aimed to provide a comprehensive overview of the oral resistome in periodontal health and disease, with a focus on advances in profiling antibiotic-resistance genes using next-generation sequencing technologies. Methods: A narrative synthesis of the literature was conducted, focusing on studies that evaluated antibiotic-resistance genes within the oral microbiome using culture-independent molecular approaches. Emphasis was placed on next-generation sequencing-based metagenomic methods and their application in identifying, quantifying, and comparing resistome profiles in health and periodontitis. Results: The oral resistome comprises a diverse array of antibiotic-resistance genes harbored within the oral microbial community. Periodontitis is associated with dysbiotic shifts in the subgingival microbiome, accompanied by an increased prevalence and diversity of resistance genes. Traditional culture- and amplification-based techniques, including polymerase chain reaction and DNA microarrays, are limited by low throughput, primer dependency, and amplification bias. In contrast, next-generation sequencing enables high-throughput, comprehensive, and unbiased profiling of the resistome, facilitating the detection of known and novel resistance determinants across the entire microbial community. These approaches have revealed significant variations in resistome composition between health and disease states and have enhanced understanding of resistance gene dynamics and dissemination. Conclusions: Next-generation sequencing has revolutionized oral resistome research by enabling detailed and comprehensive analysis of antibiotic-resistance genes. The integration of metagenomic approaches provides critical insights into the diversity, dynamics, and clinical implications of the resistome in periodontal health and disease. This knowledge is essential for developing targeted antimicrobial strategies and addressing the growing challenge of antimicrobial resistance in periodontal therapy.