Comparative Analysis of Oral Microbiota in Caries and Periodontal Disease Using Cultivation and Mass Spectrometry

Abstract Aim: The classical microbiological approach does not always allow for accurate strain identification. The study aims to determine the microflora of patients with caries, its complications, and periodontal pathologies in two ways: cultivation and mass spectrometry. Methods: Swabs from the tooth cavity and gingival junction were inoculated onto selective media, and low molecular weight species-specific fatty acids were isolated from blood samples, followed by chromatographic separation and mass spectrometry. Microbial species were identified as 12 in Group II and 9 in Group I. Statistical analysis included the chi-square test for categorical data, Mann–Whitney U test for colony-forming units (CFU)/mL comparisons, and Kruskal–Wallis test for multi-group comparisons. A P value of <0.05 and 95% confidence intervals were used to assess significance. Results: Traditional cultivation identified 12 microbial species in the periodontal group (Group II) and nine in the caries group (Group I), with Streptococcus viridans (77%) being the most frequently observed. Other strains, including Streptococcus pyogenes (20%), Staphylococcus epidermidis (16%), and Saccharomyces sp. (14%), exceeded the permissible titer of 10 4 CFU/mL in several cases. High-performance liquid chromatography (HPLC-MS) demonstrated superior sensitivity, identifying 56 microbial strains, 13 of which exceeded the permissible titer. Notable findings included elevated titers of S. epidermidis , E. lenta , and Kingella sp. across both groups. Statistical analysis revealed significant differences in microbial diversity and abundance between groups ( P ≤ 0.05), with subgroup analyses highlighting associations between microbial patterns and disease severity. These observations underscore the critical advantage of HPLC-MS in detecting low-abundance or fastidious microorganisms, providing deeper insights into microbial composition and potential strain-specific virulence factors. Conclusion: The results obtained can aid in selecting the appropriate antibiotic class when needed. Mass spectrometry demonstrated clear advantages over traditional methods, including higher sensitivity, accuracy, and the ability to detect a greater number of strains exceeding permissible titers. These findings are valuable for improving diagnostics and personalizing treatment for patients with caries and periodontal diseases, establishing mass spectrometry as a promising tool in clinical practice.