Bacteriological diagnosis of oral infections in the genomic and proteomic

Abstract

Introduction: The bacteriological diagnosis of oral infections has evolved significantly with the development of genomic and proteomic techniques, overcoming the limitations of traditional culture-based methods. Objective: This systematic review aims to critically evaluate the available evidence on the applicability, accuracy, and limitations of genomic and proteomic techniques in the diagnosis of oral infections. Materials and methods: This study was conducted through a retrospective, systemic documentary search on bacteriological diagnosis of oral infections in the genomic and proteomic era, following the guidelines of the PRISMA methodology. Results: Finally, the results of this research are shown, in which 15 studies published between 2015 and 2024 were analyzed, demonstrating that massive sequencing and MALDI-TOF mass spectrometry reach sensitivities of 92-98% in the identification of periodontal pathogens such as Porphyromonas gingivalis, Treponema denticola and Aggregatibacter actinomycetemcomitans, compared to 65-70% of conventional cultures. These technologies allow the detection of non-cultivable species (53.3% of the studies analyzed) and the characterization of virulence mechanisms, such as factors regulated by oxidative stress in 90% of A. actinomycetemcomitans cases. In addition, significant associations between oral dysbiosis and systemic diseases (OR: 3.2 for cardiovascular pathologies) have been identified through the analysis of salivary protein biomarkers (AUC: 0.89 for diabetes). The integration of genomic, proteomic, and ecological approaches, such as the IMPEDE model and the "keystone pathogen" concept, represents the future of personalized diagnosis and treatment of oral infections. Conclusion: Genomic and proteomic techniques have improved the diagnosis of oral infections, overcoming the limitations of traditional culture-based methods, allowing pathogens to be identified and their virulence and antimicrobial resistance studied.