Abstract
Biomarkers represent promising aids in periodontitis, host-mediate diseases of the tooth-supporting tissues. We assessed the diagnostic potential of matrix metalloproteinase-8 (MMP-8), tartrate-resistant acid phosphatase-5 (TRAP-5), and osteoprotegerin (OPG) to discriminate between healthy patients’, mild and severe periodontitis sites. Thirty-one otherwise healthy volunteers with and without periodontal disease were enrolled at the Faculty of Dentistry, University of Chile. Periodontal parameters were examined and gingival crevicular fluid was sampled from mild periodontitis sites (M; n = 42), severe periodontitis sites (S; n = 59), and healthy volunteer sites (H; n = 30). TRAP-5 and OPG were determined by commercial multiplex assay and MMP-8 by the immunofluorometric (IFMA) method. STATA software was used. All biomarkers showed a good discrimination performance. MMP-8 had the overall best performance in regression models and Receiver Operating Characteristic (ROC) curves, with high discrimination of healthy from periodontitis sites (area under the curve (AUC) = 0.901). OPG showed a very high diagnostic precision (AUC ≥ 0.95) to identify severe periodontitis sites (S versus H + M), while TRAP-5 identified both healthy and severe sites. As conclusions, MMP-8, TRAP-5, and OPG present a high precision potential in the identification of periodontal disease destruction, with MMP-8 as the most accurate diagnostic biomarker.
Highlights
Periodontitis is a group of microbial-induced diseases characterized by gingival inflammation and host-mediated destruction of the tooth supporting tissues
In relation to biomarker levels in healthy and periodontitis sites according to severity (Table 2), matrix metalloproteinase-8 (MMP-8) had the highest levels in severe periodontitis sites (464.20 ng/mL), followed by mild periodontitis sites (270.82 ng/mL), and healthy sites (60.49 ng/mL), with statistically-significant differences among all groups observed in the adjusted multilevel linear regression model (p ≤ 0.01)
Significantly-higher levels of tartrate-resistant acid phosphatase-5 (TRAP-5) and OPG were found in severe periodontitis sites (478.59 and 53.3 ng/mL, respectively) in comparison to mild periodontitis sites (177.89 and 23.24 ng/mL, respectively) (p < 0.01), and healthy sites (56.79 and 13.12 ng/mL, respectively) (p < 0.01)
Summary
Periodontitis is a group of microbial-induced diseases characterized by gingival inflammation and host-mediated destruction of the tooth supporting tissues. The pathophysiology of the disease involves the activation of immune–inflammatory responses that trigger periodontal attachment loss and marginal alveolar bone destruction that can end up, in severe cases, in tooth mobility and final tooth loss, as well as higher risk of non-communicable diseases [1,2]. Despite the current knowledge of periodontal diseases’ etiology and therapy [4,5], current diagnostic tools are mainly restricted to clinical and radiographic findings that represent past events of the disease (bleeding on probing, probing depth, clinical attachment loss, and radiographic bone loss) [6], and do not always exert the ability to detect the disease in its most incipient forms. Periodontal research has focused on finding effective diagnostic molecular biomarkers to assist clinicians in the risk-assessment and decision-making process, as the adjustment of the therapy to the patients’ individual needs. The new classification of periodontal diseases opened up to the future incorporation of biomarkers to aid in the case definition and classification of periodontal diseases by severity and complexity (“stage”) and risk of progression (“grade”), especially in the early detection of initial forms of the disease [7]
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