Abstract
In the present study, we propose a novel diagnostic approach, using 3 different salivary markers, representing periodontal pathogen burden, inflammation, and tissue degradation, for detecting periodontitis. The salivary concentrations ofPorphyromonas gingivalis, interleukin-1β, and matrix metalloproteinase-8, available from salivary specimens of 165 subjects (84 subjects with advanced periodontitis and 81 controls), were calculated together to obtain a cumulative risk score (CRS). In the calculation of CRS, the concentrations of each marker were divided into tertiles, and cumulative sub-score per each subject were calculated by the multiplication of the tertile values. Three CRS groups, indicating the lowest, medium, or highest risk, were formed with the cumulative sub-scores. Logistic regression analysis and ROC curves were performed to study the association of CRS with periodontitis. The results indicate that CRS, calculated from the 3 salivary biomarkers, is associated with advanced periodontitis more strongly than any of the markers individually. CRS offers a novel, non-invasive model for advanced periodontitis risk categorization that is especially useful in large population surveys where a periodontal examination is not feasible.
Highlights
Periodontitis forms a group of infection-induced inflammatory diseases, initiated by imbalance between pathogenic microorganisms in subgingival biofilm, affecting tooth-supporting soft tissues and alveolar bone [1]
Data collection time-resolved immunofluorometric assay (IFMA), and Porphyromonas gingivalis with a quantitative real-time PCR assay [7,13,14]
The increase in the diagnostic accuracy was demonstrated in the receiver operating characteristics (ROC) analyses, where the area under curve (AUC) value increased from 0.694–0.710 up to 0.766
Summary
Periodontitis forms a group of infection-induced inflammatory diseases, initiated by imbalance between pathogenic microorganisms in subgingival biofilm, affecting tooth-supporting soft tissues and alveolar bone [1]. The traditional diagnosis of periodontitis is based on clinical and radiographic assessments of periodontal tissues. When assessing clinically the periodontal health status in large-scale health surveys, a full periodontal examination turns to be laborious and expensive, requiring trained dental professionals [2]. The most desirable goal in health care promotion and delivery would be to monitor the periodontal health status and the onset, progression, and treatment outcome of periodontal diseases through non-invasive means. As an collected and non-invasive specimen, saliva has been used as a diagnostic fluid in medicine [3, 4]. Bacterial products (lipopolysaccharide; LPS, enzymes), host-originated enzymes, cytokines, and bone turnover biomarkers have been found in saliva of periodontitis patients in relation to their controls [3,4]
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