Abstract
ObjectivesN-benzoyl-DL-arginine peptidase (trypsin-like peptidase) is specifically produced by certain strains of periodontitis-associated bacteria. We aimed to examine the effectiveness of an objectively quantified trypsin-like peptidase activity assay (TLP-AA) for detecting severe periodontitis.MethodsThe study population included 347 adults (108 men and 239 women; average age, 43.3 years) who underwent a full-mouth periodontal examination. Specimens for the TLP-AA were obtained using tongue swabs. Using a color reader, the TLP-AA results were obtained as a* values, with higher positive a* values indicating an increased intense enzymatic activity. The predictive validity of the TLP-AA results for severe periodontitis was assessed using receiver operating characteristic curve analysis and the periodontitis case definition provided by the Centers for Disease Control and Prevention/American Academy of Periodontology as the gold standard. Furthermore, multivariable logistic regression analyses were performed to predict severe periodontitis using the TLP-AA results and health characteristics, as the exposure variables.ResultsSevere periodontitis was observed in 5.2% of the participants. TLP-AA had high diagnostic accuracy for severe periodontitis, with an area under the curve of 0.83 (95% confidence interval [CI]: 0.75–0.92). The cut-off score for the a* value that best differentiated individuals with severe periodontitis was 0.09, with a sensitivity of 83% and specificity of 77%. Multivariable logistic regression analyses revealed that the TLP-AA results were significantly associated with severe periodontitis after adjusting for health characteristics (adjusted odds ratios: 1.90 [95% CI: 1.37–2.62] for the a* value).ConclusionsObjectively quantified TLP-AA results are potentially useful for detecting severe periodontitis in epidemiological surveillance.
Highlights
Periodontitis, severe periodontitis, is associated with serious adverse health events, including cardiovascular disease and death [1, 2]
Quantified trypsin-like peptidase activity assay (TLP-AA) results are potentially useful for detecting severe periodontitis in epidemiological surveillance
The a value was associated with severe periodontitis in the univariable model
Summary
Periodontitis, severe periodontitis, is associated with serious adverse health events, including cardiovascular disease and death [1, 2]. The clinical examination may place individuals at risk of bacteremia development [4]. The surveillance of periodontitis at the population level remains challenging. This is mirrored by the current situation in Japan, where periodontitis surveillance at the community level or workplace is not performed frequently [5, 6]. According to a recent survey conducted by the Japan Dental Association [7], approximately 70% of the survey participants reported that they did not visit the dentist regularly, indicating that many individuals do not undergo periodontal health surveillance
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