AUTHOR=Manenzhe Shumani Charlotte , Koutras Sandra , Zwane Nompumelelo Benedicta , Masilana Aubrey Isaac , Shangase Sindisiwe Londiwe 

TITLE=The impact of Filifactor alocis on the severity of periodontitis among diabetic and non-diabetic patients: a narrative review

JOURNAL=Frontiers in Dental Medicine

VOLUME=5

YEAR=2024

URL=https://www.frontiersin.org/journals/dental-medicine/articles/10.3389/fdmed.2024.1408839

DOI=10.3389/fdmed.2024.1408839

ISSN=2673-4915

ABSTRACT=<p>The extensive studies on <italic>Filifactor alocis (Fa)</italic> show a positive association with periodontitis, demonstrating elevated <italic>Fa</italic> levels compared to traditional periodontal pathogens in severe disease. Periodontitis is a chronic multifactorial disease induced by a dysbiotic microbiota in a susceptible host whilst diabetes is an established risk factor for periodontitis. Diabetes has been shown to alter the subgingival microbiota into distinct microbial communities which favours the shift towards disease. It is these very distinct subgingival microbiota that are believed to contribute to the high prevalence and severity of periodontitis in diabetic patients. This dysbiotic microbiota constitute traditional periodontal pathogens which include among others the red complex triad (<italic>Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia</italic>), <italic>Aggregatibacter actinomycetemcomitans</italic>, the orange complex (<italic>Fusobacterium nucleatum, Prevotella intermedia</italic> etc.) and other emerging pathogens such as <italic>Fa</italic> that were previously unrecognised as role players in the pathogenesis of periodontitis. <italic>Fa</italic> is an asaccharolytic anaerobic gram-positive rod (AAGPR) currently considered to be one of the potential drivers of periodontitis progression and worsening through its unique virulence characteristics. Various mechanisms through which <italic>Fa</italic> contributes to the pathogenesis and severity of periodontitis have been reported. The mechanisms involved in the bidirectional relationship between periodontitis and diabetes are continuously being explored in order to enhance individualised preventative and management approaches in affected patients. This review aims to report on this emerging periodontal pathogen and its capacity to influence dysbiosis within a complex subgingival microbial community; including its potential role in the bidirectional relationship between diabetes and periodontitis. This review will highlight <italic>Fa</italic> as a potential prognostic indicator for disease worsening, which will help improve management protocols for periodontitis and diabetes.</p>