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Trichomonas tenax and periodontal diseases: a concise review

Published online by Cambridge University Press:  06 June 2017

MATHIEU MARTY ,
MATHIEU LEMAITRE ,
PHILIPPE KÉMOUN ,
JEAN-JACQUES MORRIER  and
PAUL MONSARRAT
MATHIEU MARTY*
Affiliation:
Paul Sabatier University, Dental Faculty, Department of Pediatric Dentistry, Toulouse University Hospital, Toulouse, France
MATHIEU LEMAITRE
Affiliation:
Paul Sabatier University, Dental Faculty, Department of Biological Sciences, Toulouse University Hospital, Toulouse, France Université de Lyon, Université Lyon 1, Faculté d'Odontologie & Hospices Civils de Lyon, Service d'Odontologie, Lyon, France
PHILIPPE KÉMOUN
Affiliation:
Paul Sabatier University, Dental Faculty, Department of Biological Sciences, Toulouse University Hospital, Toulouse, France Université de Lyon, Université Lyon 1, Faculté d'Odontologie & Hospices Civils de Lyon, Service d'Odontologie, Lyon, France
JEAN-JACQUES MORRIER
Affiliation:
Paul Sabatier University, Dental Faculty, Department of Anatomical Sciences and Radiology, Toulouse University Hospital, Toulouse, France
PAUL MONSARRAT
Affiliation:
Université de Lyon, Université Lyon 1, Faculté d'Odontologie & Hospices Civils de Lyon, Service d'Odontologie, Lyon, France STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, INP-ENVT, Inserm U1031, UPS, Toulouse, France
*
*Corresponding author: D.D.S, UFR Odontologie de Toulouse, 3, chemin des maraîchers 31062 Toulouse Cedex 9, France. E-mail: martymat@hotmail.fr
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Summary

Periodontal diseases (gingivitis and periodontitis), result from a disruption of the host–oral microbiome homoeostasis. Whereas the pathological role of some specific bacterial strains during periodontal diseases is well documented, the impact of parasites in periodontium pathophysiology is still under debate. This review aims to collect data about the prevalence and the potential role of Trichomonas tenax during periodontal diseases. Data from 47 studies revealed that T. tenax prevalence in diseased periodontium ranged from 0 to 94·1%. The prevalence of oral protozoan infections was found to be largely greater in patients with periodontal diseases than with healthy periodontium. The parasite detection was mainly performed by direct microscopy. Trichomonas tenax presence was clearly correlated with periodontal disease. The high heterogeneity of its periodontal prevalence may be correlated with the diversity of the population screened (age, sex, systemic diseases), and the methods used for diagnosis. This protozoan seems to have the capacity to be involved in the inflammatory process of gum disease. Animal experimentation, using relevant physiopathological models of periodontitis, needs to be performed to investigate the ability of T. tenax to cause and/or worsen the disease. Further investigations using standardized experimental designs of epidemiologic studies are also needed.

Keywords

Trichomonasperiodontal diseasesparasitic diseases
Type
Review Article
Information
Parasitology , Volume 144 , Issue 11 , September 2017 , pp. 1417 - 1425
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Copyright
Copyright © Cambridge University Press 2017 

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Footnotes

†

These authors contributed equally to this work.

References

REFERENCES

Abualqomsaan, M., Töz, S. O., Yolasiğmaz, A. and Turgay, N. (2010). The investigation of Entamoeba gingivalis and Trichomonas tenax in a group of patients with periodontal disease. Turkiye Parazitolojii Dergisi 34, 91–94.Google Scholar
Alcaide, M. L., Feaster, D. J., Duan, R., Cohen, S., Diaz, C., Castro, J. G., Golden, M. R., Henn, S., Colfax, G. N. and Metsch, L. R. (2016). The incidence of Trichomonas vaginalis infection in women attending nine sexually transmitted diseases clinics in the USA. Sexually Transmitted Infections 92, 58–62. doi:10.1136/sextrans-2015-052010.Google Scholar
Al-hamiary, A. K., Kezar, Y. and Al-Khafaji, Y. A. (2011). Prevalence of oral protozoa in periodontitis and gingivitis patients whose attended to clinics periodontics, Dentistry College\Babylon University. Journal of Kufa University for Biology 3, 1–7.Google Scholar
Al-Khayat, F. A. A.-M. (2016). The prevalence of oral protozoa Trichomonas tenax in some patients with gingivitis. Journal of Baghdad College Dentistry 28, 179–182.Google Scholar
Alou, L., Giménez, M. J., Manso, F., Sevillano, D., Torrico, M., González, N., Granizo, J. J., Bascones, A., Prieto, J., Maestre, J. R. and Aguilar, L. (2009). Tinidazole inhibitory and cidal activity against anaerobic periodontal pathogens. International Journal of Antimicrobial Agents 33, 449–452. doi:10.1016/j.ijantimicag.2008.10.012.Google Scholar
Athari, A., Soghandi, L., Haghighi, A. and Kazemi, B. (2007). Prevalence of oral Trichomoniasis in patients with periodontitis and gingivitis using PCR and direct smear. Iranian Journal of Public Health 36, 33–37.Google Scholar
Baker, J. L., Bor, B., Agnello, M., Shi, W. and He, X. (2017). Ecology of the oral microbiome: beyond bacteria. Trends in Microbiology 25, 362–374. doi:10.1016/j.tim.2016.12.012.CrossRefGoogle ScholarPubMed
Bartold, P. M. and Van Dyke, T. E. (2013). Periodontitis: a host-mediated disruption of microbial homeostasis. Unlearning learned concepts. Periodontology 2000, 62, 203–217. doi:10.1111/j.1600-0757.2012.00450.x.Google Scholar
Bastida-Corcuera, F. D., Okumura, C. Y., Colocoussi, A. and Johnson, P. J. (2005). Trichomonas vaginalis lipophosphoglycan mutants have reduced adherence and cytotoxicity to human ectocervical cells. Eukaryotic Cell 4, 1951–1958. doi:10.1128/EC.4.11.1951-1958.2005.CrossRefGoogle ScholarPubMed
Beatman, L. H. (1933). Studies on Trichomonas buccalis . Journal of Dental Research 13, 339–347. doi:10.1177/00220345330130050401.Google Scholar
Bernaola-Paredes, E., Guillén-Oneeglio, A. and Gutiérrez-Romero, F. (2012). Isolation of Trichomonas tenax in patients with chronic periodontitis in the modified thioglycolate culture medium. Kiru 9, 95–106.Google Scholar
Bhattacharjee, S., Kalbfuss, N. and Prazeres da Costa, C. (2017). Parasites, microbiota and metabolic disease. Parasite Immunology 39. doi:10.1111/pim.12390.CrossRefGoogle ScholarPubMed
Blasco-Baque, V., Serino, M., Vergnes, J.-N., Riant, E., Loubieres, P., Arnal, J.-F., Gourdy, P., Sixou, M., Burcelin, R. and Kemoun, P. (2012). High-fat diet induces periodontitis in mice through lipopolysaccharides (LPS) receptor signaling: protective action of estrogens. PLoS ONE 7, e48220. doi:10.1371/journal.pone.0048220.Google Scholar
Bonner, M., Amard, V., Bar-Pinatel, C., Charpentier, F., Chatard, J.-M., Desmuyck, Y., Ihler, S., Rochet, J.-P., Roux de La Tribouille, V., Saladin, L., Verdy, M., Gironès, N., Fresno, M. and Santi-Rocca, J. (2014). Detection of the amoeba Entamoeba gingivalis in periodontal pockets. Parasite (Paris, France) 21, 30. doi:10.1051/parasite/2014029.CrossRefGoogle ScholarPubMed
Bózner, P. and Demes, P. (1991 a). Cell-associated and extracellular proteolytic activity of an oral flagellate, Trichomonas tenax . Archives of Oral Biology 36, 77–83.Google Scholar
Bózner, P. and Demes, P. (1991 b). Degradation of collagen types I, III, IV and V by extracellular proteinases of an oral flagellate Trichomonas tenax . Archives of Oral Biology 36, 765–770.Google Scholar
Burt, B. (2005). Position paper: epidemiology of periodontal diseases. Journal of Periodontology 76, 1406–1419. doi:10.1902/jop.2005.76.8.1406.Google Scholar
Cambon, M., Petavy, A. F., Guillot, J., Glanddier, Y., Deguillaume, J. and Coulet, M. (1979). Oral protozoans and diabetes: study in 117 patients. Journal De Biologie Buccale 7, 27–30.Google ScholarPubMed
Chomicz, L., Szubińska, D., Piekarczyk, J., Wojtowicz, A., Piekarczyk, B., Starościak, B. and Fiedor, P. (2004). Occurrence of oral subclinical infections in insulin treated diabetics. Wiadomosci Parazytologiczne 50, 177–180.Google ScholarPubMed
Chunge, R. N., Manji, F. and Amwayi, P. (1988). Oral protozoa in a Kenyan population. East African Medical Journal 65, 203–207.Google Scholar
Costalonga, M. and Herzberg, M. C. (2014). The oral microbiome and the immunobiology of periodontal disease and caries. Immunology Letters 162, 22–38. doi:10.1016/j.imlet.2014.08.017.Google Scholar
Crucitti, T., Jespers, V., Mulenga, C., Khondowe, S., Vandepitte, J. and Buvé, A. (2010). Trichomonas vaginalis is highly prevalent in adolescent girls, pregnant women, and commercial sex workers in Ndola, Zambia. Sexually Transmitted Diseases 37, 223–227. doi:10.1097/OLQ.0b013e3181c21f93.Google Scholar
da Costa, R. F. M., de Souza, W., Benchimol, M., Alderete, J. F. and Morgado-Diaz, J. A. (2005). Trichomonas vaginalis perturbs the junctional complex in epithelial cells. Cell Research 15, 704–716. doi:10.1038/sj.cr.7290340.Google Scholar
de Albuquerque, R. L. C. Jr., de Melo, C. M., de Santana, W. A., Ribeiro, J. L. and Silva, F. A. (2011). Incidence of Entamoeba gingivalis and Trichomonas tenax in samples of dental biofilm and saliva from patients with periodontal disease. Revista Gaúcha de Odontologia 59, 35–40.Google Scholar
de Annan, G., Susana, E., de Nadal, T., Mercedes, M., de Valladares, R. and Elisa, R. (1993). Presencia de protozoos en la enfermedad periodontal, su relación con la profundidad de bolsa, sangrado al sondeo y microflora presente. Revista de la Asociación Odontológica Argentina 81, 230–232.Google Scholar
Devera, R., Blanco, Y., Amaya, I., Rojas, M. and Torrealba, M. (2010). Protozoarios en cavidad bucal de escolares de Ciudad Bolívar, estado Bolívar, Venezuela. Revista de la Sociedad Venezolana de Microbiología 30, 109–113.Google Scholar
Duboucher, C., Farto-Bensasson, F., Chéron, M., Peltier, J. Y., Beaufils, F. and Périé, G. (2000). Lymph node infection by Trichomonas tenax: report of a case with co-infection by Mycobacterium tuberculosis . Human Pathology 31, 1317–1321. doi:10.1053/hupa.2000.18502.Google Scholar
Dutzan, N., Konkel, J. E., Greenwell-Wild, T. and Moutsopoulos, N. M. (2016). Characterization of the human immune cell network at the gingival barrier. Mucosal Immunology 9, 1163–1172. doi:10.1038/mi.2015.136.Google Scholar
El Hayawan, I. A. and Bayoumy, M. M. (1992). The prevalence of Entamoeba gingivalis and Trichomonas tenax in periodontal disease. Journal of the Egyptian Society of Parasitology 22, 101–105.Google Scholar
El Sibaei, M. M., Abdel-Fattah, N. S., Ahmed, S. A. and Abou-Seri, H. M. (2012). Growth kinetics, antigen profiling, and proteinase activity of Egyptian Trichomonas tenax isolates derived from patients having oral infections. Experimental Parasitology 130, 416–422. doi:10.1016/j.exppara.2012.01.018.Google Scholar
Escario, A., Gómez Barrio, A., Simons Diez, B. and Escario, J. A. (2010). Immunohistochemical study of the vaginal inflammatory response in experimental Trichomoniasis. Acta Tropica 114, 22–30. doi:10.1016/j.actatropica.2009.12.002.Google Scholar
Feki, A., Molet, B., Haag, R. and Kremer, M. (1981). Protozoa of the human oral cavity (epidemiological correlations and pathogenic possibilities. Journal De Biologie Buccale 9, 155–161.Google Scholar
Fichorova, R. N., Buck, O. R., Yamamoto, H. S., Fashemi, T., Dawood, H. Y., Fashemi, B., Hayes, G. R., Beach, D. H., Takagi, Y., Delaney, M. L., Nibert, M. L., Singh, B. N. and Onderdonk, A. B. (2013). The villain team-up or how Trichomonas vaginalis and bacterial vaginosis alter innate immunity in concert. Sexually Transmitted Infections 89, 460–466. doi:10.1136/sextrans-2013-051052.CrossRefGoogle ScholarPubMed
Fuentes Cuevas, R., Ramos, L. B., De, M. A. S., Castillo Contreras, C. and Hernández-Sierra, F. (2008). Prevalencia y asociación epidemiológica de los protozoarios orales Entamoeba gingivalis y Trichomonas tenax en niños mexicanos. Reviews of ADM 65, 259–262.Google Scholar
Gazzinelli, R. T. and Denkers, E. Y. (2006). Protozoan encounters with toll-like receptor signalling pathways: implications for host parasitism. Nature Reviews. Immunology 6, 895–906. doi:10.1038/nri1978.Google Scholar
Ghabanchi, J., Zibaei, M., Afkar, M. D. and Sarbazie, A. H. (2010). Prevalence of oral Entamoeba gingivalis and Trichomonas tenax in patients with periodontal disease and healthy population in Shiraz, southern Iran. Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research 21, 89–91. doi:10.4103/0970-9290.62821.Google Scholar
Gharavi, M. J., Hekmat, S., Ebrahimi, A. and Jahani, M. R. (2006). Buccal cavity protozoa in patients referred to the faculty of dentistry in Tehran, Iran. Iranian Journal of Parasitology 1, 43–46.Google Scholar
Giazzi, J. F. (1992). Contribuição para o estado dos protozoários bucais em 700 indivíduos da população de araraquara, estado de São Paulo . Tese de Doutorado, São Paulo: Faculdade de Saúde Pública, Universidade de São Paulo.Google Scholar
Hajishengallis, G. (2015). Periodontitis: from microbial immune subversion to systemic inflammation. Nature Reviews. Immunology 15, 30–44. doi:10.1038/nri3785.Google Scholar
Khalid, A., Abdulkareem, E.-A., Kheir, E. and Aljafari, A. (2015). Commensal oral protozoa among patients attending Academic Dental Teaching Hospital, Khartoum State, Sudan. Aljouf University Medical Journal 2, 17–20.Google Scholar
Khalid, O., Kim, J. J., Duan, L., Hoang, M., Elashoff, D. and Kim, Y. (2014). Genome-wide transcriptomic alterations induced by ethanol treatment in human dental pulp stem cells (DPSCs). Genomics Data 2, 127–131. doi:10.1016/j.gdata.2014.06.011.Google Scholar
Kikuta, N., Yamamoto, A., Fukura, K. and Goto, N. (1997). Specific and sensitive detection of Trichomonas tenax by the polymerase chain reaction. Letters in Applied Microbiology 24, 193–197.Google Scholar
Kucknoor, A. S., Mundodi, V. and Alderete, J. (2009). Genetic identity and differential gene expression between Trichomonas vaginalis and Trichomonas tenax . BMC Microbiology 9, 58. doi:10.1186/1471-2180-9-58.Google Scholar
Kumar, A., Chandra, R. V., Reddy, A. A., Reddy, B. H., Reddy, C. and Naveen, A. (2015). Evaluation of clinical, antiinflammatory and antiinfective properties of amniotic membrane used for guided tissue regeneration: a randomized controlled trial. Dental Research Journal 12, 127–135.Google Scholar
Kummer, S., Hayes, G. R., Gilbert, R. O., Beach, D. H., Lucas, J. J. and Singh, B. N. (2008). Induction of human host cell apoptosis by Trichomonas vaginalis cysteine proteases is modulated by parasite exposure to iron. Microbial Pathogenesis 44, 197–203. doi:10.1016/j.micpath.2007.09.004.Google Scholar
Kurnatowska, A. (1990). Value of WHO recommendations for the assessment of oral health in patients with diagnosed Trichomonas tenax invasion. Wiadomosci Parazytologiczne 36, 245–249.Google Scholar
Kurnatowska, A. and Kurnatowska, A. (1990). Difficulties in the diagnosis of Trichomonas infection complicated by mycosis of the oral cavity. Wiadomosci Parazytologiczne 36, 237–243.Google Scholar
Kurnatowska, A. J. and Kurnatowski, P. (1999). Trichomonosomycosis of the oral cavity. Wiadomosci Parazytologiczne 45, 129–133.Google Scholar
Kurnatowska, A. J., Dudko, A. and Kurnatowski, P. (2004 a). Invasion of Trichomonas tenax in patients with periodontal diseases. Wiadomosci Parazytologiczne 50, 397–403.Google ScholarPubMed
Kurnatowska, A. J., Dudko, A. and Turkowicz, M. (2004b). Familial infections with Trichomonas tenax (O.F. Müller, 1773), Dobel, 1939. Wiadomosci Parazytologiczne 50, 35–40.Google Scholar
Lamont, R. J. and Hajishengallis, G. (2015). Polymicrobial synergy and dysbiosis in inflammatory disease. Trends in Molecular Medicine 21, 172–183. doi:10.1016/j.molmed.2014.11.004.Google Scholar
Lemaitre, M., Monsarrat, P., Blasco-Baque, V., Loubières, P., Burcelin, R., Casteilla, L., Planat-Bénard, V. and Kémoun, P. (2017). Periodontal tissue regeneration using syngeneic adipose-derived stromal cells in a mouse model. Stem Cells Translational Medicine 6, 656–665. doi:10.5966/sctm.2016-0028.Google Scholar
Leterrier, M., Morio, F., Renard, B. T., Poirier, A.-S., Miegeville, M. and Chambreuil, G. (2012). Trichomonads in pleural effusion: case report, literature review and utility of PCR for species identification. New Microbiologica 35, 83–87.Google Scholar
Li, Z. (1988). A survey of Entamoeba gingivalis and Trichomonas buccalis in Xian. Chinese Journal of Stomatology 23, 307–309.Google Scholar
Lopez-Escamilla, E., Sanchez-Aguillon, F., Alatorre-Fernandez, C. P., Aguilar-Zapata, D., Arroyo-Escalante, S., Arellano, T., Moncada-Barron, D., Romero-Valdovinos, M., Martinez-Hernandez, F., Rodriguez-Zulueta, P. and Maravilla, P. (2013). New Tetratrichomonas species in two patients with pleural empyema. Journal of Clinical Microbiology 51, 3143–3146. doi:10.1128/JCM.01056-13.Google Scholar
Mahdi, N. K. and al-Saeed, A. T. (1993). Trichomonas tenax in Basrah, Iraq. Journal of the Pakistan Medical Association 43, 261–262.Google Scholar
Maraghi, S., Azizi, A., Mousanejad, F., Rahdar, M. and Vazirianzadeh, B. (2012). 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 4, 85–89.Google Scholar
Mark Welch, J. L., Rossetti, B. J., Rieken, C. W., Dewhirst, F. E. and Borisy, G. G. (2016). Biogeography of a human oral microbiome at the micron scale. Proceedings of the National Academy of Sciences of the United States of America 113, E791–E800. doi:10.1073/pnas.1522149113.Google ScholarPubMed
Marty, M., Bonner, M. and Vaysse, F. (2015). Observation of Trichomonads infection in a child with periodontitis by direct microscopy at the dental office. Parasitology 142, 1440–1442. doi:10.1017/S0031182015000876.Google Scholar
Mehr, A. K., Zarandi, A. and Anush, K. (2015). Prevalence of oral Trichomonas tenax in periodontal lesions of down syndrome in Tabriz, Iran. Journal of Clinical and Diagnostic Research 9, ZC88–ZC90. doi:10.7860/JCDR/2015/14725.6238.Google Scholar
Menezes, C. B. and Tasca, T. (2016). Trichomoniasis immunity and the involvement of the purinergic signaling. Biomedical Journal 39, 234–243. doi:10.1016/j.bj.2016.06.007.Google Scholar
Menicanin, D., Hynes, K., Han, J., Gronthos, S. and Bartold, P. M. (2015). Cementum and periodontal ligament regeneration. Advances in Experimental Medicine and Biology 881, 207–236. doi:10.1007/978-3-319-22345-2_12.Google Scholar
Monsarrat, P., Blaizot, A., Kémoun, P., Ravaud, P., Nabet, C., Sixou, M. and Vergnes, J.-N. (2016). Clinical research activity in periodontal medicine: a systematic mapping of trial registers. Journal of Clinical Periodontology 43, 390–400. doi:10.1111/jcpe.12534.Google Scholar
Muñoz, C., Pérez, M., Orrego, P. R., Osorio, L., Gutiérrez, B., Sagua, H., Castillo, J. L., Martínez-Oyanedel, J., Arroyo, R., Meza-Cervantez, P., da Silveira, J. F., Midlej, V., Benchimol, M., Cordero, E., Morales, P., Araya, J. E. and González, J. (2012). A protein phosphatase 1 gamma (PP1γ) of the human protozoan parasite Trichomonas vaginalis is involved in proliferation and cell attachment to the host cell. International Journal for Parasitology 42, 715–727. doi:10.1016/j.ijpara.2012.03.012.Google Scholar
Nagao, E., Yamamoto, A., Igarashi, T., Goto, N. and Sasa, R. (2000). Two distinct hemolysins in Trichomonas tenax ATCC 30207. Oral Microbiology and Immunology 15, 355–359.Google Scholar
Osorio, A., Mabel, E., Ibáñez, M., Beatriz, A., Ibáñez, C. M., Mora, B., María, A., Parra, J., Urdaneta, Y. and Urdaneta, M. (2009). Entamoeba gingivalis y Trichomonas tenax en cavidad bucal de pacientes de la Clínica Integral del Adulto de la Facultad de Odontología, Maracaibo, Venezuela. Revista de la Sociedad Venezolana de Microbiología 29, 122–127.Google Scholar
Özçelık, S., Gedık, T., Gedık, R. and Malatyali, E. (2010). Investigation of the relationship between oral and dental health and presence of Entamoeba gingivalis and Trichomonas tenax . Turkiye Parazitolojii Dergisi 34, 155–159. doi:10.5152/tpd.2010.03.Google Scholar
Ozumba, U. C., Ozumba, N. and Ndiokwetu, E. M. (2004). Oral protozoa in a Nigeria population. African Journal of Clinical and Experimental Microbiology 5, 15–19.Google Scholar
Palmieri, J. R., Halverson, B. A., Sudjadi, S. T., Purnomo, and Masbar, S. (1984). Parasites found in the mouths of inhabitants of three villages of South Kalimantan (Borneo), Indonesia. Tropical and Geographical Medicine 36, 57–59.Google Scholar
Pardi, G., Perrone, M. and Mazzali de Ilja, R. (2002). Incidencia de Trichomonas tenax en pacientes con periodontitis marginal crónica. Acta Odontológica Venezolana 40, 152–159.Google Scholar
Patil, M. J., Nagamoti, J. M. and Metgud, S. C. (2012). Diagnosis of Trichomonas vaginalis from vaginal specimens by wet mount microscopy, in pouch TV culture System, and PCR. Journal of Global Infectious Diseases 4, 22–25. doi:10.4103/0974-777X.93756.Google Scholar
Piekarczyk, J., Fiedor, P., Chomicz, L., Szubinska, D., Starościak, B., Piekarczyk, B., Zawadzki, P., Zebrowska, J. and Dudziński, T. (2003). Oral cavity as a potential source of infections in recipients with diabetes mellitus. Transplantation Proceedings 35, 2207–2208.Google Scholar
Ponce De León, P., Zdero, M., Vasconi, M. D., Nocito, I., Lucca, A. and Perez, B. (2001). Relation between buccal protozoa and pH and salivary IgA in patients with dental prosthesis. Revista Do Instituto De Medicina Tropical De Sao Paulo 43, 241–242.Google Scholar
Ribaux, C. L., Magloire, H., Joffre, A. and Morrier, J. J. (1983). Immunohistochemical localization of fibronectin-like protein on the cell surface of the oral flagelatte Trichomonas tenax . Journal De Biologie Buccale 11, 41–51.Google Scholar
Ribeiro, L. C., Santos, C. and Benchimol, M. (2015). Is Trichomonas tenax a parasite or a commensal? Protist 166, 196–210. doi:10.1016/j.protis.2015.02.002.Google Scholar
Roberts, L. S. and Schmidt, G. D. (2009). Other flagellated protozoa. In Foundations of Parasitology. McGraw-Hill, Boston, 728 p.Google Scholar
Sato, M., Hayashi, A., Kato, M., Nitta, H., Namikawa, I., Shiraki, M., Katsutani, Y., Iwayama, S., Hirata, K. and Kimura, K. (1985). Occurrence of oral Trichomonads (Trichomonas tenax) in subgingival plaque materials. Nihon Shishubyo Gakkai Kaishi 27, 407–415.Google Scholar
Sumaiah, I. and Rasha, A. (2012). Evaluation of Entamoeba gingivalis and Trichomonas tenax in patients with periodontitis and gingivitis and its correlation with some risk factors. Journal of Baghdad College Dentistry 24, 158–162.Google Scholar
Turkowicz, M., Tomaszewska, D. and Cielecka, D. (2004). Molecular diagnosis of oral cavity Trichomonas infections in HIV patients. Wiadomosci Parazytologiczne 50, 181–186.Google Scholar
Vráblic, J., Catár, G., Staník, R., Hromada, J. and Zitńan, D. (1987). [Occurrence of the oral flagellate, Trichomonas tenax, in children with chronic tonsillitis]. Bratislavske Lekarske Listy 88, 64–70.Google Scholar
Vráblic, J., Tomová, S., Catár, G., Randová, L. and Suttová, S. (1991). Morphology and diagnosis of Entamoeba gingivalis and Trichomonas tenax and their occurrence in children and adolescents. Bratislavske Lekarske Listy 92, 241–246.Google ScholarPubMed
Vráblic, J., Tomová, S. and Catár, G. (1992). Occurrence of the protozoa, Entamoeba gingivalis and Trichomonas tenax in the mouths of children and adolescents with hyperplastic gingivitis caused by phenytoin. Bratislavske Lekarske Listy 93, 136–140.Google Scholar
Wantland, W. W. and Lauer, D. (1970). Correlation of some oral hygiene variables with age, sex, and incidence of oral protozoa. Journal of Dental Research 49, 293–297.Google Scholar
Xiufeng, G., Qionglian, L. and Qiya, F. (2003). The survey and analysis of 427 persons with infestation of Entamoeba gingivalis and Trichomonas buccalis in Haikou City. Journal of Hainan Medical College 9, 90–92.Google Scholar
Yamamoto, A., Asaga, E., Nagao, E., Igarashi, T. and Goto, N. (2000). Characterization of the cathepsin B-like proteinases of Trichomonas tenax ATCC 30207. Oral Microbiology and Immunology 15, 360–364.Google Scholar
Yang, X., Liu, X. and Zhang, Z. (2009). Investigation on the infection of Trichomonas tenax . Journal of Shanxi Medical College for Continuing Education 2009-02.Google Scholar
Zariffard, M. R., Harwani, S., Novak, R. M., Graham, P. J., Ji, X. and Spear, G. T. (2004). Trichomonas vaginalis infection activates cells through toll-like receptor 4. Clinical Immunology (Orlando, Fla.) 111, 103–107. doi:10.1016/j.clim.2003.12.008.Google Scholar
Zawadzki, P. J., Perkowski, K., Starościak, B., Dybicz, M., Baltaza, W., Pionkowski, K. and Chomicz, L. (2016). Evaluation of selected oral cavity microbiota – risk factors of management complications in patients with masticatory system disorders. Annals of Parasitology 62, 71–76.Google Scholar
Zdero, M., Ponce de León, P., Vasconi, M. D., Nocito, I. and Lucca, A. (1999). Entamoeba gingivalis y Trichomonas tenax: hallazgo en poblaciones humanas con y sin patología bucal. Acta Bioquímica Clínica Latinoamericana Incorporada 33, 359–365.Google Scholar
Zvetkova, A., Isev, V. and Stoilova, R. (1988). Humoral immune response against Trichomonas tenax in patients with chronic catarrhal gingivitis before and after specific Fasigyn treatment. Stomatologiia. Stomatology 70, 4–8.Google Scholar