Identification of bacterial species in subgingival plaque as a risk factor for periodontitis in peri-menopausal and post-menopausal women using or not using hormone replacement therapy (HRT)

Background: The objective of this study wasto assess the implications of the menopause inpatients treated or not with HRT on their oralhealth, with particular reference to quantitativeand qualitative changes of the major periodontalpathogens which may lead to homeostaticalterations in the balance of the microbiotain favour of some species most frequently involvedin the etio-pathogenesis of periodontaldiseases. In order to assess this, the effects ofHRT on oral microbiota has been taken into account,using as a comparison the microbiota ofpostmenopausal women, who did not undergoHRT.Methods: We examined 64 patients aged between45 and 80 years (mean age 59 years) inmenopause, who accessed the Institute of Pathology,Obstetrics and Gynaecology of theUniversity Hospital Vittorio Emanuele “G. Rodolico”of Catania, 60 of whom were diagnosedwith chronic periodontitis. For each patient,samples were collected from the subgingivalplaque in 4 sites in the proximity of 1st and 2ndmolar, using sterile paper points, two times (after2 years). Samples of sub-gingival plaque ofpatients were analysed using assays based onthe PCR technique, aimed to the qualitative andquantitative detection of the occurrence of conservedsequences of the 16S rRNA portion of 12of the major periodontal pathogens.Results: The main organisms detected in firstand second sampling were Campylobacter rectus,Prevotella nigrescens, Treponema denticolaand Veillonella parvula. C. rectus has been identifiedin almost 80% of patients during the firstsampling and in 31 of 34 patients in the secondsampling, including 13 patients with HRT. P.nigrescens in the first specimen was identifiedin 28 of 34 patients, while in the second samplein 30 of them, 15 of which under HRT. T. denticolawas present in the first specimen in 25patients, while in the second sample in 32 of 34,10 of which under HRT. V. parvula was found in28 of 34 patients at the first sampling and in 31patients at the second, 17 of which were underHRT.Conclusion: The use of HRT in this study didnot reduce the prevalence of the reported oralsymptoms and did not significantly affect thefrequency of bacteria isolation. Anyway, furtherstudies with long-term follow-up would beneeded to better assess the effect of HRT on theparameters of oral health.