Medical Implication of Oral Amoebiasis

摘要

Periodontal disease affects a majority of adult population. Entamoeba gingivalis is always present as confirmed by phase contrast microscopy. Tissue destruction may be caused by proteolytic enzymes in part released from host PMN leucocytes lysed by amoebas. Local consequence is destruction of the maxillary bone surrounding teeth. Elimination of E. gingivalis ensures rapid healing of chronic and aggressive form of the disease. Periodontitis in known to adversely affect glycemic control in diabetes, is associated with an increased risk of cardiovascular complication and increase risk for pre-term low birth weight delivery. Although bacterial infection is primary, oral amoebiasis has important medical implications. Periodontitis is an infectious disease, with primary bacterial etiology followed by inflammatory process leading to destruction of the supporting structures of the teeth. Main bacterial species implicated in the disease are Gram-negative, anaerobic, and facultative microorganisms. Many authors reported 100% incidence of secondary infection with E. gingivalis. Phase contrast observation in our dental practice during 20 years confirm the presence of the amoeba in all area of bone destruction. Normal health biofilm present typical morphotypes: coccoidal bacteria, non motile filaments and association of both (Fig. 1). Motility is absent. Periodontal deterioration present numerous poly-morphonuclear neutrophils, very motile bacteria, spirillae, spinnings rods and protozoa (Fig. 2). Amoebae are visible on fresh biofilm smear mounted on patient saliva and taken from deepest lesion area. Mouth and lower gastrointestinal tract share similar protozoan activities. Pathology of E. histolytica in amebic dysentery is linked to lytic activity, invasion of intestine mucosa and formation of acute liver abscess.