Candida spp. and Actinomyces spp. infections as a probable reason for resistance to periodontal therapy

Abstract

Relevance. Resistance of periodontal diseases to conservative therapy may constitute up to 7% of all clinical cases and may be due to specific pathogens. Active infection caused by Candida spp. and bacterial infection (formerly known as mycosis) caused by Actinomyces spp. are possible clinical options. Both the absence of described specific clinical manifestations and pathogen variety, ability to morphological transformation and similar unconventional approaches to microbiological diagnosis determine the continuity of the pathological process. At the same time, both the available scientific literature and our clinical work evidenced the detection of a diagnostically significant quantity of Candida spp. and Actinomyces spp. in pockets of patients with a worse response to periodontal therapy. However, most available studies used non-morphological diagnostic methods, which are hard to interpret assess ing the effect of the infectious process on the course of periodontitis. Possible options include the following: from significant etiological reasons, aggravating factors, background process or marker of systemic or local disorders to the dysbiosis caused by antibacterial therapy.
Propose. To draw the attention of dental practitioners to the peculiarities of the course of the infectious process in patients with resistance to periodontal therapy.
Conclusion. The paper presents specific characteristics of differential diagnosis, risk group assessment, comprehensive approach to local and systemic therapy based on the data from modern literature, our analytics and particular clinical cases.