Abstract
Introduction: The urease activity is produced by many oral and gastric microorganisms, which have demonstrated systemic implications as well. Urea can be detected both from saliva and gingival crevicular fluid, which could suggest that the oral cavity can act as an extragastric reservoir for many microbes leading to serious systemic diseases.
Objective: The main objective of this current study was to find out the urease activity in human dental plaque.
Methods: An analytical cross-sectional study was conducted from September to November 2023 in patients visiting the Department of Periodontology and Oral Implantology. The urease activity was detected using a rapid urease test (RUT) kit from a hundred cases diagnosed with periodontitis. All systemically healthy patients excluding patients on ongoing proton-pump inhibitor therapy were selected for the presence/absence of periodontitis as per the 2017 World Workshop classification. Data were collected and entered into Microsoft Excel, and further analysis was done using SPSS v.20.
Results: Out of 100 patients, urease activity was found positive in 85 (85%) patients. Regarding gender and age, the urease activity was not much different and was not statistically significant (P value= 0.163 and 0.382 respectively).
Conclusions: The results of this study suggest there is a high urease activity in dental plaque samples whose removal is essential to prevent our body from systemic threats like bacterial endocarditis, gastric carcinoma, etc. caused by urease-producing microorganisms.
References
Chen YYM, Weaver CA, Burne RA. Dual functions of Streptococcus salivarius urease. J Bacteriol. 2000;182(16):4667-9.
Golub L, Borden S, Kleinberg IJ. Urea content of gingival crevicular fluid and its relation to periodonal disease in humans. J Periodontal Res. 1971;6(4):243-51.
Al Nowaiser A, Roberts GJ, Trompeter RS, Wilson M, Lucas VS. Oral health in children with chronic renal failure. Paediatr Nephrol. 2003;18:39-45.
Liljemark WF, Bloomquist CG, Uhl LA, Schaffer EM, Wolff LF, Pihlstrom BL, et al. Distribution of oral Haemophilus species in dental plaque from a large adult population. Infect Immun. 1984;46(3):778-86.
Socransky SS, Haffajee ADJP. Periodontal microbial ecology. Periodontol 2000. 2005;38(1):135-87.
Dahlén G, Hassan H, Blomqvist S, Carlén AJ. Rapid urease test (RUT) for evaluation of urease activity in oral bacteria in vitro and in supragingival dental plaque ex vivo. BMC Oral Health. 2018;18:1-7.
Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. J Periodontol. 2018;89:S173-S82.
Gebara ECE, Pannuti C, Faria C, Chehter L, Mayer MPA, Lima L, et al. Prevalence of Helicobacter pylori detected by polymerase chain reaction in the oral cavity of periodontitis patients. Oral Microbiol Immunol. 2004;19(4):277-80.
Bıcak DA, Akyuz S, Kıratlı B, Usta M, Urganci N, Alev B, et al. The investigation of Helicobacter pylori in the dental biofilm and saliva samples of children with dyspeptic complaints. BMC Oral Health. 2017;17(1):67.
Sudhakar U, Anusuya CN, Ramakrishnan T, Vijayalakshmi R. Isolation of Helicobacter pylori from dental plaque: A microbiological study. J Indian Soc Periodontol. 2008 Sep;12(3):67-72.
Beck J, Papapanou P, Philips K, Offenbacher SJ. Periodontal medicine: 100 years of progress. J Dent Res. 2019;98(10):1053-62.
Herzberg MC, Meyer MW. Dental plaque, platelets, and cardiovascular diseases. Ann. Periodontal. 1998;3(1):151-60.
Coulthwaite L, Verran JJBjobs. Potential pathogenic aspects of denture plaque. Br J Biomed Sci. 2007;64(4):180-9.
Adachi K, Notsu T, Mishiro T, Yoshikawa H, Kinoshita YJ. Influence of Helicobacter pylori infection on periodontitis. J Gastroentrol Hepatol. 2019;34(1):120-3.
Hanada N, Hakuta C, Okada A, Sogabe K, Kakuta E, Endo K, et al. Opportunistic bacteria in tonsil and dental plaque are indicator for oral care. Int J Oral Sci. 2016;2(1):30-4.
Latyshev Y, Mathew A, Jacobson JM, Sturm EJ. Purulent pericarditis caused by Haemophilus parainfluenzae. Tex Heart Inst J. 2013;40(5):608-11.
Kleinberg I. Effect of urea concentration on human plaque pH levels in situ. Arch Oral Biol. 1967;12(12):1475-84.
Bowen WH. The Stephan curve revisited. Odontology. 2013;101:2-8.
Baliga S, Muglikar S, Kale RJ. Salivary pH: A diagnostic biomarker. J Indian Soc Periodontol. 2013;17(4):461-5.
Redéen S, Petersson F, Törnkrantz E, Levander H, Mårdh E, Borch K, et al. Reliability of diagnostic tests for Helicobacter pylori infection. Gastroenterol Res Pract. 2011;2011.
Vaira D, Perna F. How useful is the rapid urease test for evaluating the success of Helicobacter pylori eradication therapy? Nat Rev Gastroenterol Hepatol. 2007;4(11):600-1.
Uotani T, Graham DY. Diagnosis of Helicobacter pylori using the rapid urease test. Ann Transl Med. 2015;3(1):1-9.
Sipponen P, Hyvärinen H. Role of Helicobacter pylori in the pathogenesis of gastritis, peptic ulcer and gastric cancer. Scand J Gastroenterol. 1993;28(sup196):3-6.
Hassan H, Lingström P, Carlén A. Plaque pH in caries-free and caries-active young individuals before and after frequent rinses with sucrose and urea solution. Caries Res. 2015;49(1):18-25.
Sissons C, Hancock EJ. Urease activity in Streptococcus salivarius at low pH. Arch Oral Biol. 1993;38(6):507-16.
Anand PS, Nandakumar K, Shenoy KJ. Are dental plaque, poor oral hygiene, and periodontal disease associated with Helicobacter pylori infection? J Periodontol. 2006;77(4):692-8.
Al-Refai ANM, Fathalla SE, Nagamani R, Al-Momen S. Incidence of helicobacter pylori in dental plaque of saudi gastritis patients. J Fam Community Med. 2002;9(2):27.
Bali D, Rosamma J, Bali AJ. The Association of dental plaque and Helicobacter pylori infection in dyspeptic patients undergoing endoscopy. J Clin Diagn Res. 2010;4(1):3614-21.
Assumpção MB, Martins LC, Barbosa HPM, dos Santos Barile KA, de Almeida SS, Assumpção PP, et al. Helicobacter pylori in dental plaque and stomach of patients from Northern Brazil. World J Gasteroenterol. 2010;16(24):3033-9.