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Treponema denticola is a Gram-negative, obligate anaerobic, motile and highly proteolytic spirochete bacterium. It is one of four species of oral spirochetes to be reliably cultured, the others being Treponema pectinovorum, Treponema socranskii and Treponema vincentii [2].
Dental plaque, the precursor of periodontal disease, is a complex biofilm consisting mainly of bacteria, but also archaea, protozoa, fungi and viruses. Viruses that specifically infect bacteria—bacteriophages—are most common in the oral cavity. Viral roles in the progression of periodontal disease as of 2017 remains poorly explored. [1]
The species has been implicated in periodontal disease, as well as various tooth cavities. [1] In other cases, A. naeslundii is associated with good oral health. It is one of the first bacteria to occupy the oral cavity and colonize the tooth's surface. It has also been isolated from women with bacterial vaginosis. [2]
The most common causes for odontogenic infection to be established are dental caries, deep fillings, failed root canal treatments, periodontal disease, and pericoronitis. [2] Odontogenic infection starts as localised infection and may remain localised to the region where it started, or spread into adjacent or distant areas.
Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. [5] In its early stage, called gingivitis, the gums become swollen and red and may bleed. [5] It is considered the main cause of tooth loss for adults worldwide.
To complete the diagnosis, the extent of the disease must be assessed. This is defined as: mild (1-2mm), moderate (3-4mm) or severe (≥ 5mm) depending on the amount of attachment loss present. Radiographs such as bitewings, intra-oral periapicals or a panoramic radiograph can be taken to help assess the bone loss and aid in diagnosis.
Necrotizing gingivitis is part of a spectrum of disease termed necrotizing periodontal diseases. It is the most minor form of this spectrum, with more advanced stages being termed necrotizing periodontitis, necrotizing stomatitis, and the most extreme, cancrum oris.
The gingival tissue forms a crevice surrounding the tooth, similar to a miniature, fluid-filled moat, wherein food debris, endogenous and exogenous cells, and chemicals float. The depth of this crevice, known as a sulcus , is in a constant state of flux due to microbial invasion and subsequent immune response.