The Prevalence of Entamoeba gingivalis and Trichomonas tenax in Relation to Periodontal Disease among Patients Attending Dental Clinics in Urmia, Iran: A Cross-Sectional Study
-
Yahya Azadeh
,
Shahram Khademvatan
,
Zahra Goharfar
,
Elham Yousfi
,
Shokoufeh Shahrabi-Farahani
,
Rasool Jafari
Abstract
Background: We aimed to determine the prevalence of Entamoeba gingivalis and Trichomonas tenax in relation to periodontitis in Urmia, Northwestern Iran, in 2022.
Methods: Gingival crevicular fluid (GCF) samples were collected from133 patients and analyzed using microscopic and molecular techniques to identify parasites. Data were analyzed using SPSS software and Chi-square and Fisher's exact test.
Results: 42.1% of patients were infected with E. gingivalis and 11.3% with T. tenax. In comparison, microscopic diagnosis identified only 1.5% and 0.8% of patients infected, respectively. This highlights the increased sensitivity of molecular methods for parasite detection. A statistically significant relationship was observed between the presence of these parasites (identified by the molecular method) and several factors. Male patients had a significantly higher prevalence of E. gingivalis infection (P=0.037). Additionally, a history of diabetes (P=0.011) and cardiovascular diseases (P=0.021) was associated with a higher prevalence of E. gingivalis. The highest prevalence of E. gingivalis was observed in the 41–50-year age group (15 cases). Importantly, both E. gingivalis and T. tenax were significantly more prevalent in patients with severe periodontitis (P=0.003, P<0.001).
Conclusion: This study demonstrates a higher prevalence of E. gingivalis compared to T. tenax in the oral cavity, suggesting its potentially greater role in periodontal disease, particularly among individuals with specific risk factors. Further research is warranted to elucidate the precise contribution of these parasites to periodontitis, identify additional risk factors, and develop improved diagnostic and treatment approaches.
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20. Gharavi MJ, Hekmat S, Ebrahimi A, et al. Buccal Cavity Protozoa in Patients Referred to the Faculty of Dentistry in Tehran, Iran. Iran J Parasitol. 2006; 1(1):43-46.
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22. Maraghi S, Azizi A, Rahdar M, Vazirianzadeh B. A study on the frequency of buccal cavity protozoa in patients with periodontitis and gingivitis in Ahvaz, southwest of Iran in 2009. Jundishapur Journal of Health Sciences. 2012;4(4):85-9.
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24. García G, Ramos F, Martínez-Hernández F, et al. A new subtype of Entamoeba gingivalis: "E. gingivalis ST2, kamaktli variant". Parasitol Res. 2018;117(4):1277-84.
25. Mallat H, Podglajen I, Lavarde V, et al. Molecular characterization of Trichomonas tenax causing pulmonary infection. J Clin Microbiol. 2004;42(8):3886-7.
26. Rivera WL, Ong VA, Masalunga MC. Molecular characterization of Trichomonas vaginalis isolates from the Philippines. Parasitol Res. 2009;106(1):105-10.
27. Fadhil Ali Malaa S, Abd Ali Abd Aun Jwad B, Khalis Al-Masoudi H. Assessment of Entamoeba gingivalis and Trichomonas tenax in Patients with Chronic Diseases and its Correlation with Some Risk Factors. Arch Razi Inst. 2022;77(1):87-93.
28. Oladokun AO, Ogboru P, Opeodu OI, et al. Prevalence of Entamoeba gingivalis and Trichomonas tenax among patients with periodontal disease attending Dental Clinic, University College Hospital, Ibadan. Trop Parasitol. 2023;13(2):107-13.
29. Jin LJ, Lamster IB, Greenspan JS, et al. Global burden of oral diseases: emerging concepts, management and interplay with systemic health. Oral Dis. 2016;22(7):609-19.
30. Khabazian A, Azarnoosh F, Sadeghi SM. Evaluation of the effect of non-surgical periodontal therapy on the quality of life associated with oral health in patients with periodontitis and gingivitis referred to periodontology department of Yazd dental school. J Dental Med. 2020;33(2):63-71.
31. Newman MG, Takei H, Klokkevold PR, Carranza FA. Newman and Carranza's Clinical periodontology E-book: Elsevier Health Sciences; 2018.
32. Grossi SG, Skrepcinski FB, DeCaro T, Zambon JJ, Cummins D, Genco RJ. Response to periodontal therapy in diabetics and smokers. J Periodontol. 1996;67(10 Suppl):1094-102.
33. de Miguel-Infante A, Martinez-Huedo MA, Mora-Zamorano E, et al. Periodontal disease in adults with diabetes, prevalence and risk factors. Results of an observational study. Int J Clin Pract. 2018; e13294.
34. Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim). 2017;11(2):72-80.
35. Bahekar AA, Singh S, Saha S, et al. The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: A meta-analysis. Am Heart J. 2007;154(5):830-7.
36. Martelli ML, Brandi ML, Martelli M, et al. Periodontal disease and women's health. Curr Med Res Opin. 2017;33(6):1005-15.
37. Younis E, Elamami A. The third international conference on basic sciences & their applications Code: Zool 1010 Prevalence of Entamoeba gingivalis and Trichomonas tenax among healthy and patients with periodontal disease in Benghazi -Libya. 2020.
38. Sharifi M, Jahanimoghadam F, Babaei Z, et al. Prevalence and Associated-Factors for Entamoeba gingivalis in Adolescents in Southeastern Iran by Culture and PCR, 2017. Iran J Public Health. 2020;49(2):351-9.
2. Carrizales-Sepúlveda EF, Ordaz-Farías A, Vera-Pineda R, et al. Periodontal Disease, Systemic Inflammation and the Risk of Cardiovascular Disease. Heart Lung Circ. 2018;27(11):1327-34.
3. Liccardo D, Cannavo A, Spagnuolo G, et al. Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. Int J Mol Sci. 2019;20(6);1414.
4. Wu YY, Xiao E, Graves DT. Diabetes mellitus related bone metabolism and periodontal disease. Int J Oral Sci. 2015;7(2):63-72.
5. Murakami S, Mealey BL, Mariotti A, et al. Dental plaque–induced gingival conditions. J Clin Periodontol. 2018; 45 Suppl 20:S17-S27.
6. Ibrahim S, Abbas R. Evaluation of Entamoeba gingivalis and Trichomonas tenax in patients with periodontitis and gingivitis and its correlation with some risk factors. J Bagh Coll Dentistry. 2012;24(3):158-62.
7. Yaseen A, Mahafzah A, Dababseh D, et al. Oral Colonization by Entamoeba gingivalis and Trichomonas tenax: A PCR-Based Study in Health, Gingivitis, and Periodontitis. Front Cell Infect Microbiol. 2021;11:782805.
8. Moroz J, Kurnatowska AJ, Kurnatowski P. The in vitro activity of selected mouthrinses on the reference strains of Trichomonas tenax and Entamoeba gingivalis. Ann Parasitol. 2019; 65(3):257-265.
9. Tan Y, Li C. Protozoa and oral health: a systematic review. J Biol Regul Homeost Agents. 2021;35(1 Suppl. 1):47-54.
10. Zhang Y, Wang X, Li H, et al. Human oral microbiota and its modulation for oral health. Biomed Pharmacother. 2018;99:883-93.
11. Adamu VE, Amaechi AA, Ajaero CMU, et al. Prevalences and trends of human oral protozoan parasites. Orapuh Journal. 2020;1(2):e711.
12. Bisson C, Dridi SM, Machouart M. Assessment of the role of Trichomonas tenax in the etiopathogenesis of human periodontitis: A systematic review. PLoS One. 2019;14(12):e0226266.
13. Khafari ghosheh M, khalili B, Kheri S, et al. with gingivitis and periodontitis referring Resalat Dental Clinic, Chaleshtor in 2015. Armaghane Danesh. 2017;22(2):220-9.
14. Santos JO, Roldán WH. Entamoeba gingivalis and Trichomonas tenax: Protozoa parasites living in the mouth. Arch Oral Biol. 2023;147:105631.
15. Brown HW, Neva FA. Basic clinical parasitology: Appleton-Century-Crofts; 1983.
16. Badri M, Olfatifar M, Abdoli A, et al. Current Global Status and the Epidemiology of Entamoeba gingivalis in Humans: A Systematic Review and Meta-analysis. Acta Parasitol. 2021;66(4):1102-13.
17. John DT, Petri WA. Markell and Voge's medical parasitology-e-book: Elsevier Health Sciences; 2013.
18. Özçelık S, Gedık T, Gedık R, Malatyali E. [Investigation of the relationship between oral and dental health and presence of Entamoeba gingivalis and Trichomonas tenax]. Turkiye Parazitol Derg. 2010;34(4):155-9.
19. Eslahi AV, Olfatifar M, Abdoli A, et al. The Neglected Role of Trichomonas tenax in Oral Diseases: A Systematic Review and Meta-analysis. Acta Parasitol. 2021;66(3):715-32.
20. Gharavi MJ, Hekmat S, Ebrahimi A, et al. Buccal Cavity Protozoa in Patients Referred to the Faculty of Dentistry in Tehran, Iran. Iran J Parasitol. 2006; 1(1):43-46.
21. Ghabanchi J, Zibaei M, Afkar MD, Sarbazie A. Prevalence of oral Entamoeba gingivalis and Trichomonas tenax in patients with periodontal disease and healthy population in Shiraz, southern Iran. Indian J Dent Res. 2010;21(1):89-91.
22. Maraghi S, Azizi A, Rahdar M, Vazirianzadeh B. A study on the frequency of buccal cavity protozoa in patients with periodontitis and gingivitis in Ahvaz, southwest of Iran in 2009. Jundishapur Journal of Health Sciences. 2012;4(4):85-9.
23. Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol. 2018;45 Suppl 20:S1-S8.
24. García G, Ramos F, Martínez-Hernández F, et al. A new subtype of Entamoeba gingivalis: "E. gingivalis ST2, kamaktli variant". Parasitol Res. 2018;117(4):1277-84.
25. Mallat H, Podglajen I, Lavarde V, et al. Molecular characterization of Trichomonas tenax causing pulmonary infection. J Clin Microbiol. 2004;42(8):3886-7.
26. Rivera WL, Ong VA, Masalunga MC. Molecular characterization of Trichomonas vaginalis isolates from the Philippines. Parasitol Res. 2009;106(1):105-10.
27. Fadhil Ali Malaa S, Abd Ali Abd Aun Jwad B, Khalis Al-Masoudi H. Assessment of Entamoeba gingivalis and Trichomonas tenax in Patients with Chronic Diseases and its Correlation with Some Risk Factors. Arch Razi Inst. 2022;77(1):87-93.
28. Oladokun AO, Ogboru P, Opeodu OI, et al. Prevalence of Entamoeba gingivalis and Trichomonas tenax among patients with periodontal disease attending Dental Clinic, University College Hospital, Ibadan. Trop Parasitol. 2023;13(2):107-13.
29. Jin LJ, Lamster IB, Greenspan JS, et al. Global burden of oral diseases: emerging concepts, management and interplay with systemic health. Oral Dis. 2016;22(7):609-19.
30. Khabazian A, Azarnoosh F, Sadeghi SM. Evaluation of the effect of non-surgical periodontal therapy on the quality of life associated with oral health in patients with periodontitis and gingivitis referred to periodontology department of Yazd dental school. J Dental Med. 2020;33(2):63-71.
31. Newman MG, Takei H, Klokkevold PR, Carranza FA. Newman and Carranza's Clinical periodontology E-book: Elsevier Health Sciences; 2018.
32. Grossi SG, Skrepcinski FB, DeCaro T, Zambon JJ, Cummins D, Genco RJ. Response to periodontal therapy in diabetics and smokers. J Periodontol. 1996;67(10 Suppl):1094-102.
33. de Miguel-Infante A, Martinez-Huedo MA, Mora-Zamorano E, et al. Periodontal disease in adults with diabetes, prevalence and risk factors. Results of an observational study. Int J Clin Pract. 2018; e13294.
34. Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim). 2017;11(2):72-80.
35. Bahekar AA, Singh S, Saha S, et al. The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: A meta-analysis. Am Heart J. 2007;154(5):830-7.
36. Martelli ML, Brandi ML, Martelli M, et al. Periodontal disease and women's health. Curr Med Res Opin. 2017;33(6):1005-15.
37. Younis E, Elamami A. The third international conference on basic sciences & their applications Code: Zool 1010 Prevalence of Entamoeba gingivalis and Trichomonas tenax among healthy and patients with periodontal disease in Benghazi -Libya. 2020.
38. Sharifi M, Jahanimoghadam F, Babaei Z, et al. Prevalence and Associated-Factors for Entamoeba gingivalis in Adolescents in Southeastern Iran by Culture and PCR, 2017. Iran J Public Health. 2020;49(2):351-9.
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| Issue | Vol 21 No 2 (2026) | |
| Section | Original Article(s) | |
| Keywords | ||
| Periodontal disease Prevalence Entamoeba gingivalis Trichomonas tenax Iran | ||
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How to Cite
1.
Azadeh Y, Khademvatan S, Goharfar Z, Yousfi E, Shahrabi-Farahani S, Jafari R. The Prevalence of Entamoeba gingivalis and Trichomonas tenax in Relation to Periodontal Disease among Patients Attending Dental Clinics in Urmia, Iran: A Cross-Sectional Study. Iran J Parasitol. 2026;21(2):247-257.
