Bacteriophages for periodontal pathogens control: A systematic review

Faced with the growing challenge of bacterial resistance to antibiotics, bacteriophages emerge as a promising alternative due to their specificity and ability to lyse specific bacteria. This systematic review aims to analyze the efficacy of bacteriophage therapy in controlling the growth of periodontal pathogen.

The protocol was registered in PROSPERO (CRD42023479696). The review followed PRISMA guidelines, utilizing a PICOS framework. Studies were identified through searches in seven databases (Embase, LILACS, PubMed, SCOPUS, Web of Science, Google Scholar and ProQuest) up to November 2024.

In vitro studies were evaluating the use of bacteriophages for this purpose were considered eligible. References were selected through a two-phase process. RoBDEMAT was used to assess the risk of bias. The certainty of the cumulative evidence was evaluated using the GRADE criteria.

Eight studies were included, all demonstrating bacteriophages are effective in controlling periodontopathogenic bacteria growth. Four periodontal pathogen bacteria were analyzed, including Aggregatibacter actinomycetemcomitans (n = 3), Fusobacterium nucleatum (n = 3), Streptococcus gordonii (n = 2), and Porphyromonas gingivalis (n = 1). Eleven different types of bacteriophages were described, including: S1249 (n = 2), ΦSG005 (n = 2), JD-Fnp1 (n = 1), d-Fnp2 (n = 1), JD-Fnp3 (n = 1), JD-Fnp4 (n = 1), JD-Fnp5 (n = 1), FNU1 (n = 1), Aabφ01 (n = 1), Aabφ01-1 (n = 1), and Fnp02 (n = 1). The predominant method for evaluating bacterial growth was optical density measurement (n = 7) colony-forming unit (CFU) (n = 3).

Bacteriophage therapy effectively controls periodontal pathogenic bacteria in vitro, offering a possibility promising strategy for treating periodontitis, especially in antimicrobial-resistant cases. However, further research is needed to validate these findings in more complex models, such as multispecies biofilms and clinical settings.

This study underscores the potential of bacteriophages as an innovative and targeted alternative for managing periodontal disease.