Abstract
Periodontitis is a chronic inflammation of the periodontium caused by persistent bacterial infection that leads to the breakdown of connective tissue and bone. Because the ability to reconstruct the periodontium is limited after alveolar bone loss, early diagnosis and intervention should be the primary goals of periodontal treatment. However, periodontitis often progresses without noticeable symptoms, and many patients do not seek professional dental care until the periodontal destruction progresses to the point of no return. Furthermore, the current diagnosis of periodontitis depends on time-consuming clinical measurements. Therefore, there is an unmet need for near-patient testing to diagnose periodontitis. Saliva is an optimal biological fluid to serve as a near-patient diagnostic tool for periodontitis. Recent developments in point-of-care (POC) testing indicate that a diagnostic test for periodontitis using saliva is now technically feasible. A number of promising salivary biomarkers associated with periodontitis have been reported. A panel of optimal biomarkers must be carefully selected based on the pathogenesis of periodontitis. The biggest hurdle for the POC diagnosis of periodontitis using saliva may be the process of validation in a large, diverse patient population. Therefore, we propose the organization of an International Consortium for Biomarkers of Periodontitis, which will gather efforts to identify, select, and validate salivary biomarkers for the diagnosis of periodontitis.
Highlights
Periodontitis is a chronic inflammation of the periodontium caused by persistent bacterial infection that leads to the breakdown of connective tissue and bone
The diagnosis of periodontitis using saliva has a limitation in detecting disease activity at each individual tooth site; traditional clinical measurements are required in order to accomplish this
When medical doctors prescribe bisphosphonate or other medicines associated with medication-related osteonecrosis of the jaw (MRONJ), they can consider the periodontal status of their patients in advance to prevent the development of MRONJ, a common complication of medication combined with tooth extraction (Katsarelis et al, 2015)
Summary
Periodontitis is a chronic inflammation of the periodontium caused by persistent bacterial infection that leads to the breakdown of connective tissue and bone (Ji et al, 2014). Periodontitis is currently diagnosed using radiography and clinical measurements of probing pocket depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL) (Salvi et al, 2008) These traditional clinical measurements are time-consuming and yield limited information because they are indicators of previous periodontal disease rather than present disease activity. The diagnosis of periodontitis using saliva has a limitation in detecting disease activity at each individual tooth site; traditional clinical measurements are required in order to accomplish this. In this respect, the diagnosis of periodontitis using saliva must be realized as a point-of-care (POC) testing. Recent developments in POC testing indicate that the diagnosis of periodontitis using saliva is technically feasible
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