{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T11:48:27Z","timestamp":1789645707499,"version":"4.0.0"},"reference-count":88,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Down syndrome (DS) is a genetic disorder associated with early-onset periodontitis and other periodontal diseases (PDs). The present work aimed to systematically review the scientific literature reporting studies in vivo on oral microbiota features in subjects with DS and related periodontal health and to highlight any correlation and difference with subjects not affected by DS, with and without PDs. PubMed, Web of Science, Scopus and Cochrane were searched for relevant studies in May 2021. The participants were subjects affected by Down syndrome (DS) with and without periodontal diseases; the study compared subjects with periodontal diseases but not affected by DS, and DS without periodontal diseases; the outcomes were the differences in oral microbiota\/periodontopathogen bacterial composition among subjects considered; the study design was a systematic review. Study quality was assessed with risk of bias in non-randomized studies of interventions (ROBINS-I). Of the 954 references retrieved, 26 studies were considered. The conclusions from the qualitative assessment of the papers revealed an increasing knowledge over the last years of the microbiota associated with DS and their periodontal diseases, in comparison with healthy subjects and subjects with other kinds of mental disabilities. Few data have emerged on the mycobiome and virobiome of DS, hence, further investigations are still necessary.<\/jats:p>","DOI":"10.3390\/ijms22179251","type":"journal-article","created":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T09:53:23Z","timestamp":1630058003000},"page":"9251","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Oral Microbiota Features in Subjects with Down Syndrome and Periodontal Diseases: A Systematic Review"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4773-6694","authenticated-orcid":false,"given":"Maria","family":"Contaldo","sequence":"first","affiliation":[{"name":"Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberta","family":"Lucchese","sequence":"additional","affiliation":[{"name":"Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6613-9254","authenticated-orcid":false,"given":"Antonio","family":"Romano","sequence":"additional","affiliation":[{"name":"Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6467-2039","authenticated-orcid":false,"given":"Fedora","family":"Della Vella","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, University of Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3401-776X","authenticated-orcid":false,"given":"Dario","family":"Di Stasio","sequence":"additional","affiliation":[{"name":"Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7330-7247","authenticated-orcid":false,"given":"Rosario","family":"Serpico","sequence":"additional","affiliation":[{"name":"Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9030-3739","authenticated-orcid":false,"given":"Massimo","family":"Petruzzi","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, University of Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s12929-015-0138-y","article-title":"Down syndrome: An insight of the disease","volume":"22","author":"Asim","year":"2015","journal-title":"J. Biomed. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1542\/peds.2009-0745","article-title":"Prevalence of Down syndrome among children and adolescents in 10 regions of the United States","volume":"124","author":"Shin","year":"2009","journal-title":"Pediatrics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1002\/mrdd.20157","article-title":"Epidemiology of Down syndrome","volume":"13","author":"Sherman","year":"2007","journal-title":"Ment. Retard. Dev. Disabil. Res. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"157","DOI":"10.4103\/0971-6866.92092","article-title":"Cytogenetic and comorbidity profile of Down syndrome in Mansoura University Children\u2019s Hospital, Egypt","volume":"17","author":"Yahia","year":"2011","journal-title":"Indian J. Hum. Genet."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/j.1525-1470.2007.00412.x","article-title":"Mucocutaneous findings in 100 children with Down syndrome","volume":"24","author":"Daneshpazhooh","year":"2007","journal-title":"Pediatr. Derm."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Contaldo, M., Santoro, R., Romano, A., Loffredo, F., Di Stasio, D., Della Vella, F., Scivetti, M., Petruzzi, M., Serpico, R., and Lucchese, A. (2021). Oral Manifestations in Children and Young Adults with Down Syndrome: A Systematic Review of the Literature. Appl. Sci., 11.","DOI":"10.3390\/app11125408"},{"key":"ref_7","first-page":"35","article-title":"Association between denture stomatitis, candida species and diabetic status","volume":"33","author":"Contaldo","year":"2019","journal-title":"J. Biol. Regul. Homeost. Agents"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1177\/039463201302600309","article-title":"Assessment of host defence mechanisms induced by Candida species","volume":"26","author":"Paoletti","year":"2013","journal-title":"Int. J. Immunopathol. Pharm."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1902\/jop.1989.60.5.238","article-title":"Defective neutrophil chemotaxis in Down\u2019s syndrome patients and its relationship to periodontal destruction","volume":"60","author":"Izumi","year":"1989","journal-title":"J. Periodontol."},{"key":"ref_10","first-page":"251","article-title":"Phagocytic function in Down syndrome\u2014II. Bactericidal activity and phagocytosis","volume":"24","author":"Barkin","year":"1980","journal-title":"J. Ment. Defic. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1542\/peds.56.1.123","article-title":"T system immune-deficiency in Down\u2019s syndrome","volume":"56","author":"Levin","year":"1975","journal-title":"Pediatrics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"61","DOI":"10.3389\/fmed.2018.00061","article-title":"The Continuum of Aging and Age-Related Diseases: Common Mechanisms but Different Rates","volume":"5","author":"Franceschi","year":"2018","journal-title":"Front. Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Moreau, M., Benhaddou, S., Dard, R., Tolu, S., Hamz\u00e9, R., Vialard, F., Movassat, J., and Janel, N. (2021). Metabolic diseases and Down syndrome: How are they linked together?. Biomedicines, 9.","DOI":"10.3390\/biomedicines9020221"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Contaldo, M., Lucchese, A., Lajolo, C., Rupe, C., Di Stasio, D., Romano, A., Petruzzi, M., and Serpico, R. (2021). The oral microbiota changes in orthodontic patients and effects on oral health: An overview. J. Clin. Med., 10.","DOI":"10.3390\/jcm10040780"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Cuenca, M., Mar\u00edn, M.J., N\u00f3voa, L., O\u2032Connor, A., S\u00e1nchez, M.C., Blanco, J., Limeres, J., Sanz, M., Diz, P., and Herrera, D. (2021). Periodontal Condition and Subgingival Microbiota Characterization in Subjects with Down Syndrome. Appl. Sci., 11.","DOI":"10.3390\/app11020778"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1177\/0022034517693566","article-title":"GBD Oral Health Collaborators. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990\u20132015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors","volume":"96","author":"Kassebaum","year":"2017","journal-title":"J. Dent. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/j.1600-0757.2011.00425.x","article-title":"The global burden of periodontal disease: Towards integration with chronic disease prevention and control","volume":"60","author":"Petersen","year":"2012","journal-title":"Periodontol 2000"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1399-302X.2009.00544.x","article-title":"Progression of chronic periodontitis can be predicted by the levels of Porphyromonas gingivalis and Treponema denticola in subgingival plaque","volume":"24","author":"Byrne","year":"2009","journal-title":"Oral Microbiol. Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1177\/0022034510376402","article-title":"Destructive and protective roles of cytokines in periodontitis: A re-appraisal from host defense and tissue destruction viewpoints","volume":"89","author":"Garlet","year":"2010","journal-title":"J. Dent. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1111\/jcpe.12935","article-title":"A new classification scheme for periodontal and peri-implant diseases and conditions-Introduction and key changes from the 1999 classification","volume":"45","author":"Caton","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1002\/JPER.17-0721","article-title":"Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions","volume":"89","author":"Papapanou","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_22","first-page":"27","article-title":"Systemic effects of periodontitis","volume":"18","author":"Loos","year":"2006","journal-title":"Ann. R. Australas. Coll. Dent. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.it.2013.09.001","article-title":"Immunomicrobial pathogenesis of periodontitis: Keystones, pathobionts, and host response","volume":"35","author":"Hajishengallis","year":"2014","journal-title":"Trends Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/jcpe.13275","article-title":"Mechanical plaque removal of periodontal maintenance patients: A systematic review and network meta-analysis","volume":"47","author":"Slot","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s11914-016-0330-3","article-title":"Osteoporosis and Periodontitis","volume":"14","author":"Wang","year":"2016","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Lauritano, D., Moreo, G., Carinci, F., Borgia, R., Lucchese, A., Contaldo, M., Della Vella, F., Bernardelli, P., Moreo, G., and Petruzzi, M. (2019). Aging and Oral Care: An Observational Study of Characteristics and Prevalence of Oral Diseases in an Italian Cohort. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16193763"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"615486","DOI":"10.1155\/2015\/615486","article-title":"Mechanisms of Bone Resorption in Periodontitis","volume":"2015","author":"Hienz","year":"2015","journal-title":"J. Immunol. Res."},{"key":"ref_28","unstructured":"Baron, S. (1996). Microbiology of Dental Decay and Periodontal Disease. Medical Microbiology, University of Texas Medical Branch. [4th ed.]. Chapter 99."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Contaldo, M., Itro, A., Lajolo, C., Gioco, G., Inchingolo, F., and Serpico, R. (2020). Overview on Osteoporosis, Periodontitis and Oral Dysbiosis: The Emerging Role of Oral Microbiota. Appl. Sci., 10.","DOI":"10.3390\/app10176000"},{"key":"ref_30","first-page":"273","article-title":"Periodontal disease and bone pathogenesis: The crosstalk between cytokines and porphyromonas gingivalis","volume":"29","author":"Ballini","year":"2015","journal-title":"J. Biol. Regul. Homeost. Agents"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"9587971","DOI":"10.1155\/2020\/9587971","article-title":"Sex Hormones and Inflammation Role in Oral Cancer Progression: A Molecular and Biological Point of View","volume":"2020","author":"Contaldo","year":"2020","journal-title":"J. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1332710","DOI":"10.1080\/20002297.2017.1332710","article-title":"Comorbidity of periodontal disease: Two sides of the same coin? An introduction for the clinician","volume":"9","author":"Holmstrup","year":"2017","journal-title":"J. Oral. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1111\/idh.12451","article-title":"Early Childhood Oral Health Impact Scale (ECOHIS): Literature review and Italian validation","volume":"18","author":"Contaldo","year":"2020","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Contaldo, M., Fusco, A., Stiuso, P., Lama, S., Gravina, A.G., Itro, A., Federico, A., Itro, A., Dipalma, G., and Inchingolo, F. (2021). Oral Microbiota and Salivary Levels of Oral Pathogens in Gastro-Intestinal Diseases: Current Knowledge and Exploratory Study. Microorganisms, 9.","DOI":"10.3390\/microorganisms9051064"},{"key":"ref_35","first-page":"143","article-title":"Focus on periodontal disease and development of endocarditis","volume":"32","author":"Carinci","year":"2018","journal-title":"J. Biol. Regul. Homeost. Agents"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.jormas.2020.03.003","article-title":"Bisphosphonate-related osteonecrosis of the jaws and dental surgery procedures in children and young people with osteogenesis imperfecta: A systematic review","volume":"121","author":"Contaldo","year":"2020","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"540","DOI":"10.3389\/fendo.2019.00540","article-title":"The Role of Oxidative Stress and Hormones in Controlling Obesity","volume":"10","author":"Pinto","year":"2019","journal-title":"Front Endocrinol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/s11657-019-0643-9","article-title":"An investigation of the bidirectional link between osteoporosis and periodontitis","volume":"14","author":"Penoni","year":"2019","journal-title":"Arch. Osteoporos."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1038\/nrrheum.2017.132","article-title":"The case for periodontitis in the pathogenesis of rheumatoid arthritis","volume":"13","author":"Potempa","year":"2017","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1161\/CIRCULATIONAHA.115.020324","article-title":"Periodontitis Increases the Risk of a First Myocardial Infarction: A Report from the PAROKRANK Study","volume":"133","author":"Buhlin","year":"2016","journal-title":"Circulation"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"eaau3333","DOI":"10.1126\/sciadv.aau3333","article-title":"Porphyromonas gingivalis in Alzheimer\u2019s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors","volume":"5","author":"Dominy","year":"2019","journal-title":"Sci. Adv."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1563405","DOI":"10.1080\/20002297.2018.1563405","article-title":"Assessing the role of Porphyromonas gingivalis in periodontitis to determine a causative relationship with Alzheimer\u2019s disease","volume":"11","author":"Singhrao","year":"2019","journal-title":"J. Oral. Microbiol."},{"key":"ref_43","unstructured":"Kwon, T., Lamster, I.B., and Levin, L. (2020). Current concepts in the management of periodontitis. Int. Dent. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1902\/jop.2006.050332","article-title":"Supragingival Plaque May Modify the Effects of Subgingival Bacteria on Attachment Loss","volume":"77","author":"Tezal","year":"2006","journal-title":"J. Periodontol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1111\/j.1600-051X.1998.tb02419.x","article-title":"Microbial complexes in subgingival plaque","volume":"25","author":"Socransky","year":"1998","journal-title":"J. Clin. Periodontol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/j.1399-302X.2007.00411.x","article-title":"Microbial complexes in supragingival plaque","volume":"23","author":"Haffajee","year":"2008","journal-title":"Oral Microbiol. Immunol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"5002","DOI":"10.1128\/JB.00542-10","article-title":"The Human Oral Microbiome","volume":"192","author":"Dewhirst","year":"2010","journal-title":"J. Bacteriol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"R42","DOI":"10.1186\/gb-2012-13-6-r42","article-title":"Composition of the adult digestive tract bacterial microbiome based on seven mouth surfaces, tonsils, throat and stool samples","volume":"13","author":"Segata","year":"2012","journal-title":"Genome Biol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1177\/0022034520914594","article-title":"Profiling of Oral Bacterial Communities","volume":"99","author":"Wade","year":"2020","journal-title":"J. Dent. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1177\/039463200702000211","article-title":"Cyclooxygenase Isozymes in Oral Squamous Cell Carcinoma: A Real-Time RT-PCR Study with Clinic Pathological Correlations","volume":"20","author":"Pannone","year":"2007","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1865690","DOI":"10.1080\/20002297.2020.1865690","article-title":"Oral microbiome in down syndrome and its implications on oral health","volume":"13","author":"Willis","year":"2020","journal-title":"J. Oral Microbiol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"N\u00f3voa, L., S\u00e1nchez, M.D.C., Blanco, J., Limeres, J., Cuenca, M., Mar\u00edn, M.J., Sanz, M., Herrera, D., and Diz, P. (2020). The Subgingival Microbiome in Patients with Down Syndrome and Periodontitis. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082482"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/j.adaj.2018.03.010","article-title":"Periodontal disease in patients with Down syndrome: A systematic review","volume":"149","author":"Scalioni","year":"2018","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1902\/jop.1968.39.6.326","article-title":"Prevalence of Bacteroides melaninogenicus in the gingival crevice area of institutionalized trisomy 21 and cerebral palsy patients and normal children","volume":"39","author":"Meskin","year":"1968","journal-title":"J. Periodontol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1111\/j.1399-302X.1992.tb00033.x","article-title":"Actinobacillus actinomycetemcomitans, Capnocytophaga and Porphyromonas gingivalis in subgingival plaque of adolescents with Down\u2019s syndrome","volume":"7","author":"Linder","year":"1992","journal-title":"Oral Microbiol. Immunol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1111\/j.1754-4505.1996.tb00838.x","article-title":"Serum antibody response to Actinobacillus actinomycetemcomitans in Down\u2019s syndrome","volume":"16","author":"Santos","year":"1996","journal-title":"Spec. Care Dent."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1902\/jop.1997.68.7.626","article-title":"The relationship between gingivitis and the serum antibodies to the microbiota associated with periodontal disease in children with Down\u2019s syndrome","volume":"68","author":"Morinushi","year":"1997","journal-title":"J. Periodontol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1902\/annals.1998.3.1.370","article-title":"Early-onset periodontitis associated with Down\u2019s syndrome--clinical interventional study","volume":"3","author":"Cichon","year":"1998","journal-title":"Ann. Periodontol."},{"key":"ref_61","first-page":"141","article-title":"Neutrophil chemotaxis in Down syndrome and normal children to Actinobacillus actinomycetemcomitans","volume":"22","author":"Sreedevi","year":"1998","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1046\/j.0909-8836.1999.eos107202.x","article-title":"Changes of periodontal status in patients with Down syndrome during a 7-year period","volume":"107","author":"Agholme","year":"1999","journal-title":"Eur. J. Oral Sci."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1902\/jop.2000.71.2.249","article-title":"Periodontopathic bacteria in children with Down syndrome","volume":"71","author":"Amano","year":"2000","journal-title":"J. Periodontol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/j.1754-4505.2000.tb00019.x","article-title":"The relationship between place BANA reactivity and clinical parameters in subjects with mental disabilities","volume":"20","author":"Figueiredo","year":"2000","journal-title":"Spec. Care Dent."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1902\/jop.2000.71.3.376","article-title":"Herpesviruses and periodontopathic bacteria in Trisomy 21 periodontitis","volume":"71","author":"Hanookai","year":"2000","journal-title":"J. Periodontol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1902\/jop.2001.72.3.368","article-title":"Relationship of periodontopathic bacteria with early-onset periodontitis in Down\u2019s syndrome","volume":"72","author":"Amano","year":"2001","journal-title":"J. Periodontol."},{"key":"ref_67","first-page":"1004","article-title":"Absence of a specific subgingival microflora in adults with Down\u2019s syndrome","volume":"28","year":"2001","journal-title":"J. Clin. Periodontol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1034\/j.1399-302X.2001.160610.x","article-title":"Supragingival and subgingival microbiota of adult patients with Down\u2019s syndrome. Changes after periodontal treatment","volume":"16","author":"Sakellari","year":"2001","journal-title":"Oral Microbiol. Immunol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1034\/j.1600-0765.2002.01637.x","article-title":"Identification of a new variant of fimA gene of Porphyromonas gingivalis and its distribution in adults and disabled populations with periodontitis","volume":"37","author":"Nakagawa","year":"2002","journal-title":"J. Periodontal. Res."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1111\/j.1600-051X.2005.00737.x","article-title":"Periodontal conditions and subgingival microflora in Down syndrome patients. A case-control study","volume":"32","author":"Sakellari","year":"2005","journal-title":"J. Clin. Periodontol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"417","DOI":"10.17796\/jcpd.36.4.w805wm3r52474g24","article-title":"Aggregatibacter actinomycetemcomitans in Down\u2019s syndrome children","volume":"36","year":"2012","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1111\/j.1600-0765.2011.01459.x","article-title":"Subgingival microbiota in adult Down syndrome periodontitis","volume":"47","author":"Khocht","year":"2012","journal-title":"J. Periodontal. Res."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"289","DOI":"10.17796\/jcpd.37.3.d70710016518p58n","article-title":"Characterization of periodontal biofilm in Down syndrome patients: A comparative study","volume":"37","author":"Haubek","year":"2013","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"728","DOI":"10.4103\/0972-124X.147408","article-title":"Assessment of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in Down\u2019s syndrome subjects and systemically healthy subjects: A comparative clinical trial","volume":"18","author":"Ahmed","year":"2014","journal-title":"J. Indian Soc. Periodontol."},{"key":"ref_75","first-page":"ZC88","article-title":"Prevalence of Oral Trichomonas tenax in Periodontal Lesions of Down Syndrome in Tabriz, Iran","volume":"9","author":"Mehr","year":"2015","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s10096-014-2268-7","article-title":"The effect of conventional mechanical periodontal treatment on red complex microorganisms and clinical parameters in Down syndrome periodontitis patients: A pilot study","volume":"34","author":"Tanaka","year":"2015","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Faria Carrada, C., Almeida Ribeiro Scalioni, F., Evangelista Cesar, D., Lopes Devito, K., Ribeiro, L.C., and Almeida Ribeiro, R. (2016). Salivary Periodontopathic Bacteria in Children and Adolescents with Down Syndrome. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0162988"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"525","DOI":"10.13005\/bpj\/1403","article-title":"Identification of Tannerella Forsythia and Treponema Denticola in Down Syndrome Subjects and Healthy Subjects with Periodontal Disease\u2014A PCR Study","volume":"11","author":"Ahmed","year":"2018","journal-title":"Biomed. Pharmacol. J."},{"key":"ref_79","first-page":"229","article-title":"Problems and proposals for recording gingivitis and plaque","volume":"25","author":"Ainamo","year":"1975","journal-title":"Int. Dent. J."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1902\/jop.1972.43.1.38","article-title":"The plaque control record","volume":"43","author":"Drake","year":"1972","journal-title":"J. Periodontol."},{"key":"ref_81","first-page":"281","article-title":"Development of the World Health Organization (WHO) community periodontal index of treatment needs (CPITN)","volume":"32","author":"Ainamo","year":"1982","journal-title":"Int. Dent. J."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3109\/00016356408993968","article-title":"Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal ondition","volume":"22","author":"Silness","year":"1964","journal-title":"Acta Odontol. Scand."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"533","DOI":"10.3109\/00016356309011240","article-title":"Periodontal disease in pregnancy.I. Prevalence and severity","volume":"21","author":"Silness","year":"1963","journal-title":"Acta Odontol. Scand."},{"key":"ref_84","first-page":"777","article-title":"An introduction to growth of the human face from infancy to adulthood","volume":"18","author":"Hellman","year":"1932","journal-title":"Int. J. Orthod."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1177\/00220345000790090501","article-title":"Prevalence of specific genotypes of Porphyromonas gingivalis fimA and periodontal health status","volume":"79","author":"Amano","year":"2000","journal-title":"J. Dent. Res."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1177\/154405910408301006","article-title":"The highly leukotoxic JP2 clone of Actinobacillus actinomycetemcomitans and progression of periodontal attachment loss","volume":"83","author":"Haubek","year":"2004","journal-title":"J. Dent. Res."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"The NIH HMP Working Group, Peterson, J., Garges, S., Giovanni, M., McInnes, P., Wang, L., Schloss, J.A., Bonazzi, V., McEwen, J.E., and Wetterstrand, K.A. (2009). NIH HMP Working Group. The NIH human microbiome project. Genome Res., 19, 2317\u20132323.","DOI":"10.1101\/gr.096651.109"},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Human Microbiome Project Consortium (2012). Structure, function and diversity of the healthy human microbiome. Nature, 486, 207\u2013214.","DOI":"10.1038\/nature11234"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/22\/17\/9251\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:52:59Z","timestamp":1760165579000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/22\/17\/9251"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,26]]},"references-count":88,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["ijms22179251"],"URL":"https:\/\/doi.org\/10.3390\/ijms22179251","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,26]]}}}