The Bacteria-Fungi-Phage Interplay in Periodontitis and Peri-Implantitis.

OBJECTIVE

This review aims to summarize current evidence on the interactions among bacteria, fungi, and bacteriophages in periodontitis and peri-implantitis, and to discuss their ecological significance, pathogenic mechanisms, and potential clinical implications.

SUBJECTS AND

METHODS

This review synthesizes current insights into the roles of the oral microbiome in these diseases, with a focus on the critical interplay between bacteria, fungi, and bacteriophages.

RESULTS

Our analysis demonstrates that disease progression is marked by a shift toward polymicrobial synergy. Keystone pathogens and opportunistic fungi engage in intricate interactions within biofilms, including physical coadhesion and metabolic cross-feeding, which enhance microbial resilience and virulence. Bacteriophages, acting as natural modulators of bacterial populations, emerge as a promising therapeutic approach to disrupt these pathogenic communities. This bacteria-fungi-phage consortium synergistically modulates host immune responses, fostering chronic inflammation and tissue destruction.

CONCLUSION

An integrated, multikingdom perspective on the oral ecosystem is critical for clinical advancement. Future strategies should prioritize personalized interventions that combine multiomics biomarker analysis with targeted therapies to effectively disrupt polymicrobial biofilms, restore homeostasis, and overcome antimicrobial resistance.