Changes in the Salivary Metabolic Profile of Generalized Periodontitis Patients after Non-surgical Periodontal Therapy: A Metabolomic Analysis Using Nuclear Magnetic Resonance Spectroscopy.

Filippo Citterio,Alberto Sobrero,Mario Aimetti,Francesca Dego,Giovanni Nicolao Berta,Federica Romano,Giovanni Iaderosa,Gaia Meoni,Silvia Grossi,Leonardo Tenori,Matteo Corana

doi:10.3390/jcm9123977

Abstract

Pattern analysis of the salivary metabolic profile has been proven accurate in discriminating between generalized periodontitis (GP) patients and healthy individuals (HI), as this disease modifies the salivary concentrations of specific metabolites. Due to the scarcity of data from previous studies, this study aimed to evaluate if non-surgical periodontal therapy (NST) could affect the metabolomic profile in GP patients’ saliva and if it compares to that of HI. Unstimulated salivary samples were collected from 11 HI and 12 GP patients before and 3 months after NST. Nuclear Magnetic Resonance (NMR) spectroscopy, followed by a supervised multivariate statistical approach on entire saliva spectra and partial least square (PLS) discriminant analysis, were performed to obtain metabolic profiles. In the GP group, periodontal treatment improved all clinical parameters, but not all the diseased sites were eradicated. PLS revealed an accuracy of 100% in distinguishing between metabolic profiles of GP patients before and after NST. Orthogonal projection to latent structure was able to discriminate between the three groups of subjects with an accuracy of 85.6%. However, the post-NST metabolic profile of GP patients could not be completely assimilated to that of HI. Although NST may produce significant changes in the metabolic profile, GP patients maintained a distinctive fingerprint compared to HI.

Highlights

Periodontitis is a chronic inflammatory disease that leads to the loss of periodontal attachment, resorption of alveolar bone, and, if left untreated, to tooth loss
Saliva samples were collected from 12 generalized periodontitis (GP) patients (7 females and 5 males, mean age of 62 ± 4.9 years) and 11 healthy individuals (HI) (6 females and 5 males, mean age of 23.8 ± 0.4 years)
Three months after completion of treatment, full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS) decreased significantly in the GP group compared to baseline values (p < 0.001)

Summary

Introduction

Periodontitis is a chronic inflammatory disease that leads to the loss of periodontal attachment, resorption of alveolar bone, and, if left untreated, to tooth loss. It is spread worldwide and affects a large proportion of adult subjects [1]. Periodontitis is caused by a dysbiosis between the host and the bacterial biofilm that colonizes the dental surfaces. The mechanical removal of the biofilm is effective in improving clinical parameters, reducing inflammation and restoring the host-microbial symbiotic state [3,4]. The diagnosis of periodontitis (together with the assessment of treatment outcome) is primarily based on clinical and radiographic examination [5]

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