MOLECULAR MECHANISMS OF ORAL-INTESTINAL BACTERIAL TRANSLOCATION AND AN INTERDISCIPLINARY APPROACH TO EARLY PREVENTION OF COLORECTAL CANCER

Abstract

This study addresses the pathogenetic mechanisms driving the Oral-Gut axis, specifically looking at how chronic periodontitis fuels inflammatory bowel diseases and colorectal cancer. We trace both enteral and hematogenous routes allowing oral pathobionts (Fusobacterium nucleatum, Porphyromonas gingivalis, Klebsiella pneumoniae) to colonize the lower gastrointestinal tract. Our focus centers on the molecular cascade where TLR4/NF-κB and Wnt/β-catenin pathways trigger oxidative stress, dismantle E-cadherin, and force colonocyte epithelial-mesenchymal transition via Th17-mediated inflammation. To disrupt this axis, we detail a pragmatic, multilevel prevention protocol. This clinical workflow combines mechanical biofilm control (ultrasonic scaling, Air-Flow, SRP), targeted antiseptics, L. reuteri probiotics, and nutritional adjustments aimed at boosting intestinal butyrate production by Faecalibacterium prausnitzii. Finally, we introduce a combined biomarker panel (SBI, saliva PCR, hs-CRP, fecal calprotectin) to track treatment success, arguing that early dental screening is a missing link in global colon cancer prevention.