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J Periodontol. 2017 Nov;88(11):1124-1134. doi: 10.1902/jop.2017.160829. Epub 2017 Jul 3.

Chronic Periodontal Disease, Periodontal Pathogen Colonization, and Increased Risk of Precancerous Gastric Lesions.

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Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, NY.
Department of Endodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China.
Department of Periodontology, School and Hospital of Stomatology, Tongji University, Shanghai, People's Republic of China.
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Montefiore Medical Center, New York, NY.
Department of Dental Hygiene, New York University College of Dentistry.
Department of Population Health, New York University School of Medicine, New York, NY.



This study assesses the association between periodontal pathogen colonization and the potential risk of developing precancerous lesions of gastric cancer (PLGC) in a clinical setting.


Included were 35 newly diagnosed patients with PLGC and 70 age-matched individuals without PLGC. A full-mouth intraoral examination was performed to assess periodontal conditions. Stimulated whole saliva and pooled plaque samples were collected to evaluate colonization by Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans and to characterize oral microbial diversity in saliva and dental plaque.


Compared with the control group, patients with PLGC experienced higher prevalence of bleeding on probing (31.5% versus 22.4%; P <0.05), higher levels of T. denticola (P <0.01) and A. actinomycetemcomitans (P <0.01), and less bacterial diversity in their saliva (P <0.01). The final multivariate logistic regression model consisting of all key sociodemographic characteristics, oral health behavioral factors, and periodontal assessments revealed that elevated colonization with periodontal pathogens, specifically T. forsythia, T. denticola, and A. actinomycetemcomitans, decreased bacterial diversity in dental plaque, and not flossing teeth regularly was a significant predictor of increased risk of PLGC (P = 0.022).


Findings of the present study provide new evidence suggesting that periodontal pathogen burdens and bacterial diversity in the oral cavity are important factors contributing to a potentially increased risk of developing precancerous gastric lesions.


Microbiology; microbiota; periodontal diseases; precancerous conditions; risk factors

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