The Involvement of Viruses and Fungi in the Pathogenesis of Dental Infections

Abstract

Background: Tooth related oral pathologies have been described as the most common causes of tooth loss in adults. These pathologies were mostly periodontitis, pericoronitis, and periapical infection. The involvement of various bacteria in the pathogenesis of these pathologies has been thoroughly mentioned and approved in the literature. However, the variability in the severity and prognosis of these lesions among patients suggests the association of other pathogens, like viruses and fungi, in their pathogenesis. Several studies in the literature investigated the association of multiple viruses and fungi with the above-mentioned lesions, yet, a vast controversy was reached concerning this subject. Even though some studies investigated the association of some viruses or fungi with either periodontitis, pericoronitis, or periapical infection, none of these studies searched for the association of both viruses and fungi in each of these pathologies. Our study aims to fill the gap in the literature evaluating the contribution of adenovirus, Human papilloma virus-16, Epstein-Barr virus, fungi, and Candida in the pathogenesis of these pathologies.

Methods: A total of 121 patients presenting for teeth extraction were included, 81 of which we collected both healthy and infected tissues, while 40 had either healthy or infected sample. Quantitative polymerase chain reaction was utilized for pathogen detection in saliva, gingival samples, and infected tissue samples of involved subjects. Common viruses and fungi were evaluated in association with the present infection. Subjects included had either an extracted tooth extraction due to one of the dental infections, or for orthodontic or prosthetic reasons.

Results: The presence of viruses and fungi was comparable among both healthy and diseased tissues. Adenovirus showed an association only with pericoronitis, while Human papilloma virus-16 showed an association only with periapical infections. Non-candidal fungi, on the other hand, showed a positive correlation with all lesions except periapical infection. On the contrary, Epstein-Barr virus and Candida didn’t show any positive association with any of these studied lesions.

Conclusions: The contribution of viruses and fungi in the pathogenesis of these oral infections is not evident. It may be considered as a co-contributor for the progression of these lesions, yet, not a main factor initiating these pathologies. Further investigation in required in order to identify the subtype of the involved pathogen in these tooth-related oral pathologies.