1
|
Wei S, Lin T, Sáenz-Ravello G, Gao H, Zhang Y, Tonetti MS, Deng K. Diagnostic accuracy of salivary active matrix metalloproteinase (aMMP)-8 point-of-care test for detecting periodontitis in adults: A systematic review and meta-analysis. J Clin Periodontol 2024. [PMID: 38763168 DOI: 10.1111/jcpe.14000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/26/2024] [Accepted: 04/24/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE To determine the accuracy of salivary active matrix metalloproteinase (aMMP)-8 point-of-care test (POCT) for detecting periodontitis in adults, through meta-analysis. MATERIALS AND METHODS Diagnostic studies evaluating the accuracy of salivary/oral rinse aMMP-8 POCT for detecting periodontitis in adults, when compared with clinical examination, were considered eligible. A comprehensive search was performed up to 31 August 2023 through five databases. Quality Assessment of Diagnostic Accuracy Studies 2 was utilized to evaluate the methodological quality of the included articles. Meta-analysis was performed using Bayesian bivariate hierarchical model and subgroup analysis. RESULTS From 368 screened studies, 6 studies (4 cross-sectional and 2 longitudinal studies) were included in the meta-analysis. Overall, the pooled sensitivity and specificity of salivary aMMP-8-POCT for detecting periodontitis were 0.63 (95% CI: 0.41-0.82) and 0.84 (95% CI: 0.65-0.95), respectively. Subgroup analyses revealed that the 95% CI for oral fluid types, predefined diagnostic thresholds and the POCT systems largely overlapped, indicating that the differences between them may not be significant. CONCLUSION Salivary aMMP-8 POCT shows fair accuracy for detecting periodontitis. The diagnostic accuracy cannot be significantly influenced by the types of oral fluids, predefined diagnostic thresholds or the specific POCT systems used. More research is needed to confirm the clinical utility and implementation of aMMP-8 POCT in the diagnosis of periodontitis.
Collapse
Affiliation(s)
- Shimin Wei
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco School of Dentistry, San Francisco, California, USA
| | - Tingting Lin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Gustavo Sáenz-Ravello
- Center for Surveillance and Epidemiology of Oral Diseases, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Hanqi Gao
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yong Zhang
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Center, Department of Oral Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ke Deng
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
2
|
Ko YC, Lee J, Lee D, Seol YJ, Lee YM, Koo KT. Diagnostic performance of a point-of-care test device for periodontitis using human saliva: a single-center, single-blinded, confirmatory study. Clin Oral Investig 2023; 28:27. [PMID: 38147192 DOI: 10.1007/s00784-023-05443-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/17/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE Recently, matrix metalloproteinase-8 (MMP-8) has been used to diagnose periodontal disease in a point-of-care (POC) test in order to save time and cost relative to the traditional diagnostic workflow. This study aimed to investigate the diagnostic performance of INCLIX TRF MMP-8, a POC testing device for periodontitis using the area under the receiver operating characteristic curve, sensitivity, specificity, and predictive values. MATERIALS AND METHODS Full-mouth periodontal examination and radiographic analysis were used for evaluating periodontal condition based on the 2018 classification of periodontal disease. A dichotomous diagnosis of clinical periodontal condition was performed using the POC device. The relationships among periodontal condition and the concentration of MMP-8, tooth loss (TL), gingival index (GI), plaque index (PI), and alveolar bone loss (ABL) were assessed by the Spearman rank correlations (rs). RESULTS In all, 108 cases of non-periodontitis (NP) and 191 cases of periodontitis (P), including 38 cases of periodontitis stage I, 42 cases of periodontitis stage II, 99 cases of periodontitis stage III, and 11 cases of periodontitis stage IV, were enrolled in this study. Diagnostic accuracy in assessing periodontal condition with the POC device improved when it was used with participants aged ≥ 40 years. There were weak positive correlations between periodontal condition and MMP-8 and between periodontal condition and GI (rs2 = 0.1124 and rs2 = 0.0906, respectively), whereas a strong positive correlation between periodontal condition and alveolar bone loss (rs2 = 0.6877) was observed. CONCLUSION The POC device investigated in this study is a potential tool to distinguish between NP and P in individuals ≥ 40 years of age.
Collapse
Affiliation(s)
- Young-Chang Ko
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jungwon Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- One-Stop Specialty Center, Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Dongseob Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yang-Jo Seol
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yong-Moo Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| |
Collapse
|
3
|
Leppilahti JM, Tervahartiala T, Kautiainen H, Räisänen I, Ahonen M, Uitto V, Sorsa T, Mäntylä P. Correlations between different protein species of oral rinse MMP-8 and patient-related factors. Clin Exp Dent Res 2023; 9:1021-1033. [PMID: 37877535 PMCID: PMC10728547 DOI: 10.1002/cre2.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/25/2023] [Accepted: 10/12/2023] [Indexed: 10/26/2023] Open
Abstract
OBJECTIVES The aim of this study is to examine correlations between different oral rinse matrix metalloproteinase (MMP)-8 protein species in western blot (WB) analysis, quantitative MMP-8 measurements, and patient-related factors. Elevated activated MMP-8 (aMMP-8) associate with periodontitis and a diagnostic point-of-care technology has been developed based on aMMP-8. In WB, different MMP-8 protein species can be analyzed. Relative abundancy of fragmented 20-25 kDa forms in WB has been associated with and reflects MMP-8 activation and related fragmentation and elevated quantitative aMMP-8 measurements. MATERIAL AND METHODS A random sample of 192 participants from a periodontal disease screening study was used for this study. Oral rinse samples for biomarker analyses were collected before clinical periodontal examinations. aMMP-8 immunofluorometric (IFMA) and WB analysis (utilizing the same monoclonal antibody, 8708), polymorphonuclear leukocyte (PMN) elastase activity test and tissue inhibitor of metalloproteinases (TIMP)-1 ELISA levels were performed from the oral rinse samples. Distinct MMP-8 protein species were differentiated in the WB analysis. Principal component (PC) analysis was conducted to explore correlation patterns between the different species. Adjusted correlation analysis between the extracted PCs of WB and aMMP-8 IFMA levels and multilevel regression analysis were conducted to explore if the other periodontal disease-related biomarkers and clinical surrogate measures and patient-related factors are co-variating with the extracted components. RESULTS Distinct correlation patterns between the MMP-8 protein species were observed. The first four PCs explained 89% of the whole variance in PC analysis. Statistically significant correlation (p < 0.05) were observed as follows: PC1 positively with 21 kDa (r = .69) and 25 kDa fragments (r = .55) and negatively with 150 kDa complexes (r = -.46). PC2 correlated with 45 (r = .70) and 55 kDa (r = .65) activated forms, PC3 with 70-80 kDa latent proforms (r = .63) and 90-100 kDa complexes (r = .67), and PC4 with 35 kDa fragments (r = .81). There were significant correlations between quantitative (IFMA) aMMP-8 measurements and PC1 (p < 0.001), PC2 (<0.05) and PC3 (<0.05) but not with PC4. In multilevel regression models age, PMN elastase activity, TIMP-1 levels, and a number of 4-5 mm periodontal pockets were associated with PC1, nonsmoking with PC2, age and PMN elastase activity with PC3, and age and smoking with PC4. CONCLUSIONS Relative abundancy of fragmented 21-25 kDa protein species was correlated with the quantitative aMMP-8 (IFMA) measurements, which is in line with previous results. Different patient-related factors (smoking, age, proteolytic activity) may modify the formation of different MMP-8 protein species in oral rinse samples and may cause variability in quantitative aMMP-8 measurement.
Collapse
Affiliation(s)
- Jussi M. Leppilahti
- Research Unit of Population Health, Faculty of MedicineUniversity of OuluOuluFinland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial DiseasesUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Hannu Kautiainen
- Primary Health Care UnitKuopio University HospitalKuopioFinland
- Folkhälsan Research CenterHelsinkiFinland
| | - Ismo Räisänen
- Department of Oral and Maxillofacial DiseasesUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Minna‐Maija Ahonen
- Unit of Dental Health Care ServicesKeski‐Uudenmaan hyvinvointialue (KEUSOTE)HyvinkääFinland
| | - Veli‐Jukka Uitto
- Department of Oral and Maxillofacial DiseasesUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Timo Sorsa
- Department of Oral and Maxillofacial DiseasesUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
- Division of Periodontology, Department of Dental MedicineKarolinska InstitutetStockholmSweden
| | - Päivi Mäntylä
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Oral and Maxillofacial DiseasesKuopio University HospitalKuopioFinland
| |
Collapse
|
4
|
Räisänen IT, Aji NRAS, Sakellari D, Grigoriadis A, Rantala I, Pätilä T, Heikkilä P, Gupta S, Sorsa T. Active Matrix Metalloproteinase-8 (aMMP-8) Versus Total MMP-8 in Periodontal and Peri-Implant Disease Point-of-Care Diagnostics. Biomedicines 2023; 11:2885. [PMID: 38001886 PMCID: PMC10669684 DOI: 10.3390/biomedicines11112885] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 11/26/2023] Open
Abstract
Active matrix metalloproteinase-8 (aMMP-8) is a promising biomarker candidate for the modern periodontal and peri-implant disease diagnostics utilizing the chairside/point-of-care oral fluid technologies. These rapid biomarker analysis technologies utilize gingival crevicular fluid (GCF), peri-implant sulcular fluid (PISF), or mouth rinse as the oral fluid matrices that can be collected patient-friendly and non-invasively without causing bacteremia. aMMP-8, but not total or latent proMMP-8, has been shown to be a relevant biomarker to be implemented to the latest 2017 classification system of periodontitis and peri-implantitis. Thus, aMMP-8 point-of-care-testing (POCT)-but not total or latent proMMP-8-can be conveniently used as an adjunctive and preventive diagnostic tool to identify and screen the developing and ongoing periodontal and peri-implant breakdown and disease as well as predict its episodic progression. Similarly, aMMP-8 POCT provides an important tool to monitor the treatment effect of these diseases, but also other diseases such as head and neck cancer, where it can identify and predict the rapid tissue destructive oral side-effects during and after the radiotherapy. Additionally, recent studies support aMMP-8 POCT benefitting the identification of periodontitis and diabetes as the escalating risk diseases for COVID-19 infection. Overall, aMMP-8 POCT has launched a new clinical field in oral medicine and dentistry, i.e., oral clinical chemistry.
Collapse
Affiliation(s)
- Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
| | - Nur Rahman Ahmad Seno Aji
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
- Department of Periodontics, Faculty of Dentistry, Universitas Gadjah Mada, Jalan Denta No.1 Sekip Utara, Sleman, Yogyakarta 55281, Indonesia
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Health Sciences, Dental School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Andreas Grigoriadis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Health Sciences, Dental School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Dental Sector, 424 General Military Training Hospital, 564 29 Thessaloniki, Greece
| | - Iina Rantala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
| | - Tommi Pätilä
- Department of Pediatric Surgery, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
| | - Pia Heikkilä
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
| | - Shipra Gupta
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh 160012, India
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
- Department of Oral Diseases, Karolinska Institutet, 171 77 Stockholm, Sweden
| |
Collapse
|
5
|
Heikkinen AM, Sokka TT, Torppa-Saarinen E, Pimiä E, Jokinen M, Maijala M, Rantala I, Tervahartiala T, Sorsa T, Kauppila T. aMMP-8 Point-of-Care Test (POCT) Identifies Reliably Periodontitis in Patients with Type 2 Diabetes as well as Monitors Treatment Response. Diagnostics (Basel) 2023; 13:2224. [PMID: 37443617 DOI: 10.3390/diagnostics13132224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/20/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The link between diabetes and periodontitis is bi-directional: high glucose levels increase the risk of periodontitis and elevated oral fluid aMMP-8 as well as diabetic development while untreated periodontitis worsens glycaemic control. METHODS Type-2 patients (N = 161) underwent an aMMP-8 Point-of-Care Test (POCT) at diabetes clinics. If the test was positive, the patient was sent to an oral health care clinic and oral health examination, health-promoting as well as necessary treatment procedures were carried out. Only 41 patients underwent full clinical evaluations. At the end of the treatment, an aMMP-8 POCT (B) was performed and if the test was positive, the treatment was continued and a new test (C) was performed, aiming for test negativity. The glycated haemoglobin (GHbA1c) test was performed approximately 6 months from the original appointment. RESULTS GHbA1c concentrations did not decrease during the follow-up. The concentrations of aMMP-8 assessed by POCT, and clinical parameters decreased. Changes in GHbA1c and aMMP-8 levels assessed by POCT during the treatment correlated positively with each other (p < 0.01). CONCLUSION aMMP-8 POCT proved its reliability, and that its use is beneficial in the diabetes clinic, it enables identifying patients with periodontal findings reliably and guides them directly to an oral health clinic.
Collapse
Affiliation(s)
- Anna Maria Heikkinen
- Faculty of Medicine and Health Technology, University of Tampere, 33100 Tampere, Finland
- Wellbeing Services County of Pirkanmaa, 33400 Tampere, Finland
| | | | | | - Elina Pimiä
- Wellbeing Services County of Pirkanmaa, 33400 Tampere, Finland
| | - Minna Jokinen
- Wellbeing Services County of Pirkanmaa, 33400 Tampere, Finland
| | - Minna Maijala
- Wellbeing Services County of Pirkanmaa, 33400 Tampere, Finland
| | - Iina Rantala
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00014 Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00014 Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00014 Helsinki, Finland
| | - Timo Kauppila
- Faculty of Medicine and Health Technology, University of Tampere, 33100 Tampere, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00014 Helsinki, Finland
| |
Collapse
|
6
|
Yilmaz M, Sorsa T, Demir E, Gürsoy M, Suominen A, Tervahartiala T, Räisänen IT, Gürsoy UK. Accuracy of aMMP-8 point-of-care test in indicating periodontal treatment outcomes in stage III/IV periodontitis: A 24-week follow-up study. J Periodontal Res 2023; 58:325-335. [PMID: 36618000 DOI: 10.1111/jre.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To analyse the correspondence between aMMP-8 PoC test results and the clinical endpoints of non-surgical periodontal treatment in stage III/IV periodontitis. BACKGROUND The diagnostic success of the active-matrix metalloproteinase-8 (aMMP-8) point-of-care (PoC) test has been demonstrated in various studies, but the evidence of its accuracy following periodontal treatment is limited. MATERIALS AND METHODS Altogether 42 stage III/IV grade C periodontitis patients were included in this prospective diagnostic study. Clinical periodontal indices were recorded, aMMP-8 PoC test was applied and mouthrinse was collected before and at 6, 12 and 24 weeks after non-surgical periodontal treatment. Quantitative aMMP-8 levels were determined with immunofluorometric assay (IFMA) for the verification of the PoC test results. The accuracy of the aMMP-8 PoC test was assessed using previously established clinical endpoints as references. RESULTS Sensitivity and specificity of aMMP-8 PoC test to indicate clinical endpoints were ranged as follows: Sensitivity 71.4% at baseline, 39.3%-42.4% at week 6, 28.6%-32.4% at week 12 and 35.3%-42.9% at week 24; specificity 64.3%-80% at week 6, 40%-57.1% at week 12 and 56%-64.3% at week 24. CONCLUSIONS The accuracy of aMMP-8 PoC test in identifying clinical endpoints after non-surgical periodontal treatment is reduced in relation to baseline. Individual healing patterns of each diseased pocket eventually limit the accuracy of the dichotomous aMMP-8 oral rinse test during the post-treatment period.
Collapse
Affiliation(s)
- Mustafa Yilmaz
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland.,Department of Periodontology, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Esra Demir
- Department of Periodontology, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Mervi Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ulvi K Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| |
Collapse
|
7
|
Bornes R, Montero J, Correia A, Marques T, Rosa N. Peri-implant diseases diagnosis, prognosis and dental implant monitoring: a narrative review of novel strategies and clinical impact. BMC Oral Health 2023; 23:183. [PMID: 36997949 PMCID: PMC10061972 DOI: 10.1186/s12903-023-02896-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/17/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND The diagnosis of peri-implantar and periodontal relies mainly on a set of clinical measures and the evaluation of radiographic images. However, these clinical settings alone are not sufficient to determine, much less predict, periimplant bone loss or future implant failure. Early diagnosis of periimplant diseases and its rate of progress may be possible through biomarkers assessment. Once identified, biomarkers of peri-implant and periodontal tissue destruction may alert the clinicians before clinical signs show up. Therefore, it is important to consider developing chair-side diagnostic tests with specificity for a particular biomarker, indicating the current activity of the disease. METHODS A search strategy was created at Pubmed and Web of Science to answer the question: "How the molecular point-of-care tests currently available can help in the early detection of peri-implant diseases and throws light on improvements in point of care diagnostics devices?" RESULTS The PerioSafe® PRO DRS (dentognostics GmbH, Jena) and ImplantSafe® DR (dentognostics GmbH, Jena ORALyzer® test kits, already used clinically, can be a helpful adjunct tool in enhancing the diagnosis and prognosis of periodontal/peri-implantar diseases. With the advances of sensor technology, the biosensors can perform daily monitoring of dental implants or periodontal diseases, making contributions to personal healthcare and improve the current status quo of health management and human health. CONCLUSIONS Based on the findings, more emphasis is given to the role of biomarkers in diagnosing and monitoring periodontal and peri-implant diseases. By combining these strategies with traditional protocols, professionals could increase the accuracy of early detection of peri-implant and periodontal diseases, predicting disease progression, and monitoring of treatment outcomes.
Collapse
Affiliation(s)
- Rita Bornes
- Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Viseu, Portugal.
| | - Javier Montero
- Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - André Correia
- Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Viseu, Portugal
| | - Tiago Marques
- Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Viseu, Portugal
| | - Nuno Rosa
- Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Viseu, Portugal
| |
Collapse
|
8
|
Research on point-of-care tests in outpatient care in Germany: A scoping review and definition of relevant endpoints in evaluation studies. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 174:1-10. [PMID: 36055890 DOI: 10.1016/j.zefq.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/14/2022] [Accepted: 06/13/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The fast turnaround time and user-friendliness of point-of-care tests (POCTs) offer a great potential to improve outpatient health care where clinical decisions have to be made during the physician-patient encounter and time resources are limited. The aim of this scoping review is to describe the extent and nature as well as gaps in German research activities on POCT in outpatient care. In addition, we define research endpoints that should be addressed in the comprehensive evaluation of POCTs targeted for outpatient care. METHODS We performed a scoping review with a systematic literature search in Medline (via PubMed), Scopus, Web of Science, Cochrane library and Google Scholar for German publications on POCT with relevance to German outpatient care published from January 2005 to November 2020. RESULTS Our literature search identified 2,200 unique records. After literature selection 117 articles were included in this scoping review. Just over half of the articles (67/117, 57.3%) were primary research studies with original data, while one third of all the studies (33.3%) were secondary research articles (e.g., review articles). The remaining articles were clinical recommendations / position papers (7/117, 6.0%) and other types of articles (3.4%). The majority of articles focused on POCT use in infectious diseases (44/117, 37.6%), diabetic syndromes (15.4%), cardiac disease (12.0%) or coagulopathies and thrombosis (10.3%), while the remaining articles did not specify the disease (13.7%) or investigated other diseases (11.1%). Similar to international studies, most primary research studies investigated the diagnostic performance of POCT (e.g., sensitivity, specificity). Evidence beyond diagnostic accuracy remains scarce, such as the impact on therapeutic decisions and practice routines, clinical effectiveness, and user perspectives. In line with this, interventional studies (such as RCTs) on the effectiveness of POCT use in German outpatient care are limited. We define six endpoint domains that should be addressed in the evaluation of POCTs targeted for outpatient care: (i) diagnostic performance, (ii) clinical performance, (iii) time and costs, (iv) impact on clinical routines / processes, (v) perspectives of medical professionals and patients, and (vi) broader aspects. CONCLUSION There is considerable research activity on POCTs targeted for use in outpatient care in Germany. Data on their potential benefits beyond diagnostic accuracy is often lacking and should be addressed in future POCT research studies.
Collapse
|
9
|
Gupta S, Mohindra R, Singla M, Khera S, Kumar A, Rathnayake N, Sorsa T, Pfützner A, Räisänen IT, Soni RK, Kanta P, Jain A, Gauba K, Goyal K, Singh MP, Ghosh A, Kajal K, Mahajan V, Suri V, Bhalla A. Validation of a noninvasive aMMP‐8 point‐of‐care diagnostic methodology in COVID‐19 patients with periodontal disease. Clin Exp Dent Res 2022; 8:988-1001. [PMID: 35818743 PMCID: PMC9350191 DOI: 10.1002/cre2.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/30/2022] [Accepted: 05/01/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives The aim of this study was to validate an active matrix metalloproteinase (MMP‐8) point‐of‐care diagnostic tool in COVID‐19 patients with periodontal disease. Subjects, Materials, and Methods Seventy‐two COVID‐19‐positive and 30 COVID‐19‐negative subjects were enrolled in the study. Demographic data were recorded, periodontal examination carried out, and chairside tests run for evaluating the expression of active MMP‐8 (aMMP‐8) in the site with maximum periodontal breakdown via gingival crevicular fluid sampling as well as via a mouth rinse‐based kit for general disease activity. In COVID‐19‐positive patients, the kits were run again once the patients turned COVID‐19 negative. Results The overall (n = 102) sensitivity/specificity of the mouthrinse‐based kits to detect periodontal disease was 79.41%/36.76% and that of site‐specific kits was 64.71%/55.88% while adjusting for age, gender, and smoking status increased the sensitivity and specificity (82.35%/76.47% and 73.53%/88.24, respectively). Receiver operating characteristic (ROC) analysis for the adjusted model revealed very good area under the ROC curve 0.746–0.869 (p < .001) and 0.740–0.872 (p < .001) (the aMMP‐8 mouth rinse and site‐specific kits, respectively). No statistically significant difference was observed in the distribution of results of aMMP‐8 mouth rinse test (p = .302) and aMMP‐8 site‐specific test (p = .189) once the subjects recovered from COVID‐19. Conclusions The findings of the present study support the aMMP‐8 point‐of‐care testing (PoCT) kits as screening tools for periodontitis in COVID‐19 patients. The overall screening accuracy can be further increased by utilizing adjunctively risk factors of periodontitis. The reported noninvasive, user‐friendly, and objective PoCT diagnostic methodology may provide a way of stratifying risk groups, deciding upon referrals, and in the institution of diligent oral hygiene regimens.
Collapse
Affiliation(s)
- Shipra Gupta
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Ritin Mohindra
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Mohita Singla
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Sagar Khera
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Amit Kumar
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Nilminie Rathnayake
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
- Department of Dental Medicine, Division of Periodontology Karolinska Institutet Huddinge Sweden
| | - Andreas Pfützner
- Clinical Research Department, Diabetes Center and Practice Pfützner Science and Health Institute Mainz Germany
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Roop K. Soni
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Poonam Kanta
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Akanksha Jain
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Krishan Gauba
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Kapil Goyal
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Mini P. Singh
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Arnab Ghosh
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Kamal Kajal
- Department of Anaesthesia and Intensive Care Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Varun Mahajan
- Department of Anaesthesia and Intensive Care Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Vikas Suri
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Ashish Bhalla
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| |
Collapse
|
10
|
Sorsa T, Nwhator SO, Sakellari D, Grigoriadis A, Umeizudike KA, Brandt E, Keskin M, Tervahartiala T, Pärnänen P, Gupta S, Mohindra R, Bostanci N, Buduneli N, Räisänen IT. aMMP-8 Oral Fluid PoC Test in Relation to Oral and Systemic Diseases. FRONTIERS IN ORAL HEALTH 2022; 3:897115. [PMID: 35757444 PMCID: PMC9226345 DOI: 10.3389/froh.2022.897115] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/04/2022] [Indexed: 12/24/2022] Open
Abstract
The manuscript uses the previously published literature and highlights the benefits of active-matrix metalloproteinase (aMMP)-8 chairside/point-of-care (PoC) diagnostic tools as adjunctive measures in oral and systemic diseases. Previous studies suggest that as a biomarker, aMMP-8 is more precise than total MMP-8, MMP-9, MMP-2, MMP-3, MMP-13, MMP-7, MMP-1, calprotectin, myeloperoxidase (MPO), human neutrophil elastase (HNE), tissue inhibitor of matrix metalloproteinase (TIMP)-1, and bleeding of probing (BOP). Therefore, aMMP-8 could be implemented as the needed key biomarker for the new disease classification for both periodontitis and peri-implantitis. With a sensitivity to the tune of 75–85% and specificity in the range of 80–90%, lateral flow aMMP-8 PoC testing is comparable to catalytic protease activity assays for aMMP-8. The test can be further applied to estimate the glycemic status of an individual, to ascertain whether a person is at risk for COVID-19, in managing the oral side effects of radiotherapy carried in head and neck cancers, and in selected cases pertaining to reproductive health. In the future, aMMP-8 could find application as a potential systemic biomarker in diseases affecting the cardiovascular system, cancers, bacteremia, sepsis, diabetes, obesity, meningitis, as well as pancreatitis. The aMMP-8 PoCT is the first practical test in the emerging new dental clinical field, that is, oral clinical chemistry representing oral medicine, clinical chemistry, peri-implantology, and periodontology.
Collapse
Affiliation(s)
- Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Solna, Sweden
| | | | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Grigoriadis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
- 424 General Army Hospital, Thessaloniki, Greece
| | - Kehinde Adesola Umeizudike
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ella Brandt
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mutlu Keskin
- Oral and Dental Health Department, Altinbaş University, Istanbul, Turkey
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Shipra Gupta
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritin Mohindra
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nagihan Bostanci
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Solna, Sweden
| | - Nurcan Buduneli
- Department of Periodontology, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Ismo Tapani Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- *Correspondence: Ismo Tapani Räisänen
| |
Collapse
|
11
|
Deng K, Wei S, Xu M, Shi J, Lai H, Tonetti MS. Diagnostic accuracy of active matrix metalloproteinase-8 point-of-care test for the discrimination of periodontal health status: Comparison of saliva and oral rinse samples. J Periodontal Res 2022; 57:768-779. [PMID: 35575900 DOI: 10.1111/jre.12999] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/25/2022] [Accepted: 04/29/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Assessment of biomarkers, specifically active matrix metalloproteinase-8 (aMMP-8), in saliva/oral rinses is a promising diagnostic approach for periodontal health and disease. Different oral fluids have specific advantages and limitations. This study investigates the effect of sampling different fluids on the accuracy of an aMMP-8 point of care test (POCT). METHODS Unstimulated whole saliva, a first, and a second oral rinse were sequentially taken from 95 consecutive adults. aMMP-8 was quantitatively determined with a lateral flow immunoassay (index test). A full-mouth periodontal examination was used to establish a diagnosis according to the 2017 World Workshop classification of periodontal diseases (reference standard). Diagnostic measures of the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity were assessed and compared. RESULTS In all oral fluid samples, periodontitis patients (N = 61) had significantly elevated aMMP-8 levels and increased test positivity rates compared with subjects with periodontal health or gingivitis (N = 34). The intra-individual comparison showed that aMMP-8 levels were significantly higher in 1st oral rinse compared with other samples (1st oral rinse > saliva = 2nd oral rinse, p = .007). The aMMP-8 test using 1st oral rinse exhibited the best accuracy for detecting periodontitis with a sensitivity of 80.3%, a specificity of 67.8% and an AUROC of 0.740. CONCLUSIONS A 30-second oral rinse with water omitting the prerinse provided the best accuracy to discriminate periodontal health and disease with an aMMP-8 POCT. This regimen seems promising for further studies in large representative populations to verify the current findings.
Collapse
Affiliation(s)
- Ke Deng
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Shimin Wei
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Min Xu
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Junyu Shi
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hongchang Lai
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Maurizio S Tonetti
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China.,European Research Group on Periodontology, Genoa, Italy
| |
Collapse
|
12
|
Sopi M, Koçani F, Bardhoshi M, Meqa K. The Effect of Periodontal Therapy on the Level of MMP-8 in Patients with Chronic Periodontitis. Eur J Dent 2022; 17:70-75. [PMID: 35172347 PMCID: PMC9949935 DOI: 10.1055/s-0041-1742132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The complete removal of bacterial plaque and their endotoxins in deeper areas of periodontal pockets is often difficult to achieve with conventional methods such as periodontal pocket curettage. An alternative to these methods that recently gained popularity in periodontology is the diode laser, with its antibacterial effect, angiogenesis promotion as advantages. MATERIALS AND METHODS This study included 100 patients diagnosed with chronic periodontitis, with periodontal pockets up to 6 mm, and who were divided into two groups: patients treated with basic therapy and diode laser application, and patients treated with basic therapy and with flap surgery. The clinical periodontal evaluation was done before the treatment and 6 months after the treatment. Evaluation of matrix metalloproteinase (MMP)-8 as an inflammatory indicator in gingival exudate was done with dipstick immunoassay test before the treatment and 6 months later. RESULTS This study showed a more pronounced improvement of periodontal clinical parameters, as well as a decrease in MMP-8 values in gingival exudate in the laser-treated group compared with the surgically treated group. CONCLUSION The results of this study are encouraging for the use of the diode laser as a noninvasive method in the treatment of periodontal pathologies.
Collapse
Affiliation(s)
- Mirlinda Sopi
- Department of Periodontology and Oral Medicine, Dentistry School, University of Pristina, Pristina, Kosovo
| | - Ferit Koçani
- Department of Dental Pathology and Endodontics, Dentistry School, University of Pristina, Pristina, Kosovo
| | - Merita Bardhoshi
- Department of Oro-Maxillofacial Surgery, University of Medicine, Tirana, Tirana, Albania
| | - Kastriot Meqa
- Department of Periodontology and Oral Medicine, Dentistry School, University of Pristina, Pristina, Kosovo,Address for correspondence Kastriot Meqa, DDS, MSc, PhD Department of Periodontology and Oral Medicine, Dentistry School, University of PristinaRrethi I Spitalit Street, NN, QKSUK, Pristina 10000Kosovo
| |
Collapse
|
13
|
Lähteenmäki H, Tervahartiala T, Räisänen IT, Pärnänen P, Mauramo M, Gupta S, Sampson V, Rathnayake N, Heikkinen AM, Alassiri S, Gieselmann DR, Frankenberger R, Sorsa T. Active MMP-8 point-of-care (PoC)/chairside enzyme-test as an adjunctive tool for early and real-time diagnosis of peri-implantitis. Clin Exp Dent Res 2022; 8:485-496. [PMID: 35118828 PMCID: PMC9033547 DOI: 10.1002/cre2.537] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/12/2021] [Accepted: 12/14/2021] [Indexed: 01/03/2023] Open
Abstract
Objective The aim of this study was to investigate the utility of the active matrix metalloproteinase (aMMP‐8)‐point‐of‐care (PoC) test as a quantitative real‐time chair‐side diagnostic tool for peri‐implant diagnosis, as well as assess the potentially developing and ongoing risk relative to the traditional clinical methods. Background Current peri‐implant and periodontal disease diagnoses rely on clinical and radiological examinations. This case‐control study investigated the applicability of aMMP‐8‐PoC immunotest for quantitative real‐time diagnosis and monitoring of dental implants in health and disease. Methods Sixty‐eight patients visiting a specialist clinic for maintenance following dental implant placement underwent assessment of their peri‐implant health. aMMP‐8‐PoC peri‐implant sulcular fluid (PISF) lateral‐flow immunotests were performed using ImplantSafe® technology quantitated by ORALyzer®. In addition, the PISF samples were analyzed for total MMP‐8, calprotectin, and interleukin (IL)‐6 by enzyme‐linked immunosorbent assays (ELISA), aMMP‐8 by western immunoblot, and MMP‐2 and MMP‐9 by gelatin zymography. Results The aMMP‐8‐PoC test promptly recorded and reflected peri‐implant disease, differentiating it clearly from health. X‐ray findings (bone loss > 2 mm), peri‐implant pocket depth ≥ 3 mm, and bleeding on probing were significantly more prevalent among implants positive for the aMMP‐8‐PoC test. aMMP‐8/ORALyzer analysis was more precise in recording disease than total MMP‐8, calprotectin, IL‐6, MMP‐2, and MMP‐9. Conclusions The aMMP‐8‐PoC test can be conveniently implemented to alert for and detect active collagenolysis affecting peri‐implant tissues, both in the early and advanced stages of the disease. Active and fragmented MMP‐8 exhibits a strong and significant association with peri‐implantitis as compared to total MMP‐8 and other biomarkers and can be utilized as the POC/chairside biomarker of choice in the new classification of peri‐implantitis.
Collapse
Affiliation(s)
- Hanna Lähteenmäki
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Matti Mauramo
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Pathology, Haartman Institute and HUSLab, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Shipra Gupta
- Unit of Periodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Victoria Sampson
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nilminie Rathnayake
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anna-Maria Heikkinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Saeed Alassiri
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Periodontics and Community Dental Sciences, King Khalid University, Abha, Saudi Arabia
| | | | - Roland Frankenberger
- Department for Operative Dentistry, Endodontics, and Pediatric Dentistry, Philipps University Marburg and University Hospital Giessen and Marburg, Marburg, Germany
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
14
|
Martínez-García M, Hernández-Lemus E. Periodontal Inflammation and Systemic Diseases: An Overview. Front Physiol 2021; 12:709438. [PMID: 34776994 PMCID: PMC8578868 DOI: 10.3389/fphys.2021.709438] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/28/2021] [Indexed: 12/15/2022] Open
Abstract
Periodontitis is a common inflammatory disease of infectious origins that often evolves into a chronic condition. Aside from its importance as a stomatologic ailment, chronic periodontitis has gained relevance since it has been shown that it can develop into a systemic condition characterized by unresolved hyper-inflammation, disruption of the innate and adaptive immune system, dysbiosis of the oral, gut and other location's microbiota and other system-wide alterations that may cause, coexist or aggravate other health issues associated to elevated morbi-mortality. The relationships between the infectious, immune, inflammatory, and systemic features of periodontitis and its many related diseases are far from being fully understood and are indeed still debated. However, to date, a large body of evidence on the different biological, clinical, and policy-enabling sources of information, is available. The aim of the present work is to summarize many of these sources of information and contextualize them under a systemic inflammation framework that may set the basis to an integral vision, useful for basic, clinical, and therapeutic goals.
Collapse
Affiliation(s)
- Mireya Martínez-García
- Sociomedical Research Unit, National Institute of Cardiology "Ignacio Chávez", Mexico City, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico.,Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de Mèxico, Mexico City, Mexico
| |
Collapse
|
15
|
Sorsa T, Sahni V, Buduneli N, Gupta S, Räisänen IT, Golub LM, Lee HM, Pätilä T, Bostanci N, Meurman J, Pärnänen P, Nwhator SO, Singla M, Gauba K. Active matrix metalloproteinase-8 (aMMP-8) point-of-care test (POCT) in the COVID-19 pandemic. Expert Rev Proteomics 2021; 18:707-717. [PMID: 34468272 PMCID: PMC8442753 DOI: 10.1080/14789450.2021.1976151] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Active matrix metalloproteinase (aMMP)-8 utilized in point-of-care testing (POCT) is regarded as a potential biomarker for periodontal and peri-implant diseases. Various host and microbial factors eventually influence the expression, degranulation, levels and activation of aMMP-8. The type of oral fluids (saliva, mouthrinse, gingival crevicular, and peri-implant sulcular fluids [GCF/PISF], respectively) affect the analysis. AREAS COVERED With this background, we aimed to review here the recent studies on practical, inexpensive, noninvasive and quantitative mouthrinse and GCF/PISF chair-side POCT lateral flow aMMP-8 immunoassays (PerioSafe and ImplantSafe/ORALyzer) and how they help to detect, predict, monitor the course, treatment and prevention of periodontitis and peri-implantitis. The correlations of aMMP-8 POCT to other independent and catalytic activity assays of MMP-8 are also addressed. EXPERT OPINION The mouthrinse aMMP-8 POCT can also detect prediabetes/diabetes and tissue destructive oral side-effects due to the head and neck cancers' radiotherapy. Chlorhexidine and doxycycline can inhibit collagenolytic human neutrophil and GCF aMMP-8. Furthermore, by a set of case-series we demonstrate the potential of mouthrinse aMMP-8 POCT to real-time/online detect periodontitis as a potential risk disease for coronavirus disease 2019 (COVID-19). The clinical interdisciplinary utilization of aMMP-8 POCT requires additional oral, medical, and interdisciplinary studies.
Collapse
Affiliation(s)
- Timo Sorsa
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Sweden.,Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Vaibhav Sahni
- The Aesthetic Facial Surgery Clinic, Zahnärzte, Sector 56, Gurugram, Haryana, India
| | - Nurcan Buduneli
- Department of Periodontology, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Shipra Gupta
- Unit of Periodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Lorne M Golub
- Department of Oral Biology and Pathology, School of Dental Medicine, Health Sciences Center, Stony Brook University, Stony Brook, USA
| | - Hsi-Ming Lee
- Department of Oral Biology and Pathology, School of Dental Medicine, Health Sciences Center, Stony Brook University, Stony Brook, USA
| | - Tommi Pätilä
- Division of Pediatric Surgery, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Nagihan Bostanci
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Sweden
| | - Jukka Meurman
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Solomon O Nwhator
- Department of Preventive and Community Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Mohita Singla
- Unit of Periodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Krishan Gauba
- Unit of Pedodontics and Preventive Dentistry, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| |
Collapse
|
16
|
Hernández M, Baeza M, Räisänen IT, Contreras J, Tervahartiala T, Chaparro A, Sorsa T, Hernández-Ríos P. Active MMP-8 Quantitative Test as an Adjunctive Tool for Early Diagnosis of Periodontitis. Diagnostics (Basel) 2021; 11:diagnostics11081503. [PMID: 34441437 PMCID: PMC8394100 DOI: 10.3390/diagnostics11081503] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 12/16/2022] Open
Abstract
Periodontitis is a host-mediated bacterial disease that affects the tooth attachment apparatus. Metalloproteinase-8 (MMP-8), a validated biomarker, could aid in clinical diagnosis. This study aimed to evaluate the diagnostic performance of active (a) MMP-8 immunotest versus total (t) MMP-8 ELISA for quantitative real-time diagnosis and assessment of periodontitis severity at the site level. Gingival crevicular fluid (GCF) was sampled from 30 healthy, 42 mild, and 59 severe periodontitis sites from thirty-one volunteers. MMP-8 concentrations were determined by time-resolved immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using the STATA package. Both active and total MMP-8-based methods discriminated among sites according to periodontal diagnosis and severity, with a positive correlation between the two tests (p < 0.001). (a) MMP-8 models showed the best performance in receiver operating characteristic (ROC) curves to discriminate between healthy and periodontitis sites (area under the curve [AUC] = 0.89), while (t) MMP-8 demonstrated a high diagnostic precision in the detection of mild from severe periodontitis sites (AUC ≥ 0.80). The use of (a) MMP-8 and (t) MMP-8 could represent a useful adjunctive tool for periodontitis diagnosis and severity. These results support the applicability of new point-of-care methods in the monitoring of high-risk periodontal patients.
Collapse
Affiliation(s)
- Marcela Hernández
- Laboratory of Periodontal Biology, Department of Oral Pathology and Medicine, Faculty of Dentistry, University of Chile, Santiago 8380544, Chile;
| | - Mauricio Baeza
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago 8380544, Chile; (M.B.); (J.C.)
- School of Public Health, Faculty of Medicine, University of Chile, Santiago 7510040, Chile
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (I.T.R.); (T.T.); (T.S.)
| | - Johanna Contreras
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago 8380544, Chile; (M.B.); (J.C.)
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (I.T.R.); (T.T.); (T.S.)
| | - Alejandra Chaparro
- Department of Periodontology, Centro de Investigación e Innovación Biomédica (CIIB), Faculty of Dentistry, Universidad de Los Andes, Santiago 7620001, Chile;
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (I.T.R.); (T.T.); (T.S.)
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, 14152 Huddinge, Sweden
| | - Patricia Hernández-Ríos
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago 8380544, Chile; (M.B.); (J.C.)
- Correspondence: ; Tel.: +56-2-2978-1839
| |
Collapse
|
17
|
Sorsa T, Grigoriadis A, Sakellari D, Gupta S, Sahni V, Tervahartiala T, Räisänen IT. On the accuracy, sensitivity, and grading of mouthrinse active matrix metalloproteinase-8 (aMMP-8) point-of-care testing (POCT). J Clin Periodontol 2021; 48:1495-1498. [PMID: 34312914 DOI: 10.1111/jcpe.13521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/11/2021] [Indexed: 02/06/2023]
Affiliation(s)
- Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland.,Department of Oral Diseases, Karolinska Institutet, Huddinge, Sweden
| | - Andreas Grigoriadis
- Department of Periodontology, 424 General Army Hospital, Thessaloniki, Greece.,Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Shipra Gupta
- Unit of Periodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Vaibhav Sahni
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland
| | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland
| |
Collapse
|
18
|
Deng K, Pelekos G, Jin L, Tonetti MS. Diagnostic accuracy of a point-of-care aMMP-8 test in the discrimination of periodontal health and disease. J Clin Periodontol 2021; 48:1051-1065. [PMID: 33998040 PMCID: PMC8362205 DOI: 10.1111/jcpe.13485] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/29/2021] [Accepted: 04/22/2021] [Indexed: 12/17/2022]
Abstract
Aim To assess the diagnostic utility of an oral rinse active matrix metalloproteinase‐8 (aMMP‐8) point‐of‐care test (POCT) for differentiating periodontal health, gingivitis, as well as different stages and grades of periodontitis. Materials & Methods The aMMP‐8 index test was undertaken in 408 consecutive adults, followed by a full‐mouth periodontal examination. The reference standard was the 2017 World Workshop classification of periodontal diseases. Sensitivity, specificity, and the area under the receiver operating characteristic curve (AUROC) were assessed. Results 68.6% of the participants were diagnosed with periodontitis, including Stages I (15.9%), II (15.9%), III (29.7%) and IV (7.1%). A positive aMMP‐8 POCT was associated with periodontitis after adjusting for age, gender, tobacco smoking and systemic diseases, while it was unable to differentiate among the stages/grades of periodontitis and between gingivitis/periodontal health. This test showed a sensitivity of 33.2% and a specificity of 93.0% for detecting periodontitis (threshold level >10 ng/ml). The levels of aMMP‐8 adjusted by the number of teeth present (aMMP‐8/NTP) performed better for periodontitis (sensitivity: 67.1%; specificity: 68.8%). Notably, aMMP‐8/NTP were strongly predictive for Stage IV periodontitis (threshold level =0.4312 ng/ml) (sensitivity: 89.7%; specificity: 73.6%; and AUROC: 0.856). The test performance greatly improved in combination with age and smoking, with a sensitivity of 82.5%, a specificity of 84.4%, and an AUROC of 0.883. Conclusion This aMMP‐8 POCT is able to detect periodontitis with better specificity than sensitivity across the spectrum of its severity. This test may be useful for periodontal screening in conjunction with subject characteristics and/or other sensitive screening tools. Further validation studies are needed.
Collapse
Affiliation(s)
- Ke Deng
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Department of Oral Implantology, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology; National Center of Stomatology; National Clinical Research Center of Oral Diseases; Shanghai key Laboratory of Stomatology, Shanghai, China
| | - George Pelekos
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Lijian Jin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Maurizio S Tonetti
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Department of Oral Implantology, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology; National Center of Stomatology; National Clinical Research Center of Oral Diseases; Shanghai key Laboratory of Stomatology, Shanghai, China.,European Research Group on Periodontology, Genova, Italy
| |
Collapse
|
19
|
Räisänen IT, Lähteenmäki H, Gupta S, Grigoriadis A, Sahni V, Suojanen J, Seppänen H, Tervahartiala T, Sakellari D, Sorsa T. An aMMP-8 Point-of-Care and Questionnaire Based Real-Time Diagnostic Toolkit for Medical Practitioners. Diagnostics (Basel) 2021; 11:diagnostics11040711. [PMID: 33921148 PMCID: PMC8071538 DOI: 10.3390/diagnostics11040711] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 12/14/2022] Open
Abstract
The aim of this cross-sectional study is to propose an efficient strategy based on biomarkers adjunct with an interview/questionnaire covering risk factors for periodontitis for the identification of undiagnosed periodontitis by medical professionals. Active matrix metalloproteinase (aMMP)-8 levels in mouthrinse were analyzed by a point-of-care (PoC)/chairside lateral-flow immunotest, and salivary total MMP-8, total MMP-9 and calprotectin levels were analyzed by enzyme-linked immunosorbent assays (ELISAs) and active MMP-9 by gelatin zymography for 149 Greek patients. Patients underwent a full-mouth oral health examination for diagnosis according to the 2018 classification system of periodontal diseases. In addition, patient characteristics (risk factors: age, gender, education level, smoking and body mass index) were recorded. Receiver operating curve (ROC) analysis indicated better diagnostic precision to identify undiagnosed periodontitis for oral fluid biomarkers in adjunct with an interview/questionnaire compared with a plain questionnaire (i.e., risk factors): aMMP-8 AUC (95% confidence interval) = 0.834 (0.761-0.906), total MMP-8 = 0.800 (0.722-0.878), active MMP-9 = 0.787 (0.704-0.870), total MMP-9 = 0.773 (0.687-0.858) and calprotectin = 0.773 (0.687-0.858) vs. questionnaire = 0.764 (0.676-0.851). The findings of this study suggest that oral fluid biomarker analysis, such as a rapid aMMP-8 PoC immunotest, could be used as an adjunct to an interview/questionnaire to improve the precision of timely identification of asymptomatic, undiagnosed periodontitis patients by medical professionals. This strategy appears to be viable for referring patients to a dentist for diagnosis and treatment need assessment.
Collapse
Affiliation(s)
- Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland; (H.L.); (T.T.); (T.S.)
- Correspondence:
| | - Hanna Lähteenmäki
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland; (H.L.); (T.T.); (T.S.)
| | - Shipra Gupta
- Unit of Periodontology, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh 160012, India;
| | - Andreas Grigoriadis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- 424 General Military Training Hospital, 54124 Thessaloniki, Greece;
| | - Vaibhav Sahni
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences & Hospital, Panjab University, Chandigarh 160014, India;
| | - Juho Suojanen
- Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital, 00029 Helsinki, Finland;
- Department of Oral and Maxillo-Facial Surgery, Päijät-Häme Joint Authority for Health and Wellbeing, 15850 Lahti, Finland
| | - Hanna Seppänen
- Department of Surgery, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland;
- Translational Cancer Medicine Research Program, University of Helsinki, 00014 Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland; (H.L.); (T.T.); (T.S.)
| | | | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland; (H.L.); (T.T.); (T.S.)
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden
| |
Collapse
|
20
|
Kim HD, Lee CS, Cho HJ, Jeon S, Choi YN, Kim S, Kim D, Jin Lee H, Vu H, Jeong HJ, Kim B. Diagnostic ability of salivary matrix metalloproteinase-9 lateral flow test point-of-care test for periodontitis. J Clin Periodontol 2021; 47:1354-1361. [PMID: 32841379 DOI: 10.1111/jcpe.13360] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 08/03/2020] [Accepted: 08/17/2020] [Indexed: 12/20/2022]
Abstract
AIM This cross-sectional study aimed to examine the diagnostic ability of salivary matrix metalloproteinase (MMP)-9 lateral flow test (LFT) point-of-care (POC) kit and develop an algorithm for diagnosis of periodontitis. MATERIALS AND METHODS Through Seoul National Dental Hospital, 137 participants (46 LFT negatives, 91 LFT positives) were recruited. For salivary diagnostics, 150 μl of the unstimulated saliva was applied to LFT-POC kit. To make a diagnosis of periodontitis, stage II-IV in modified new international classification system was used. Covariates encompassing age, sex, smoking and obesity were evaluated through face-to-face interview. Enzyme-linked immunosorbent assay was used for quantification of salivary MMP-9. To develop a diagnostic algorithm, multivariable logistic regression analysis was used. Receiver operating characteristic curve was applied for evaluating diagnostic ability. RESULTS Diagnostic ability of salivary MMP-9 LFT-POC test was 0.82 (sensitivity of 0.92, specificity of 0.72) in total participants. Diagnostic algorithm using POC test resulted in a response equation, that is algorithm score = -3.675 + 2.877*LFT + 0.034*age + 0.121*sex + 0.372*smoking + 0.192*obesity. Diagnostic ability of the algorithm was 0.88 (sensitivity of 0.92, specificity of 0.85) with cut-off score of 0.589. CONCLUSIONS Salivary MMP-9 LFT-POC kit showed appropriate diagnostic ability for periodontitis and would be an efficient tool for screening of periodontitis.
Collapse
Affiliation(s)
- Hyun-Duck Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Chang-Soo Lee
- Department of Chemical Engineering, College of Engineering, Chungnam National University, Daejeon, Korea
| | - Hyun-Jae Cho
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Sumin Jeon
- Dental Research Institute, Seoul National University, Seoul, Korea.,Department of Oral Biology and Immunology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Young-Nim Choi
- Dental Research Institute, Seoul National University, Seoul, Korea.,Department of Oral Biology and Immunology, School of Dentistry, Seoul National University, Seoul, Korea
| | - SungTae Kim
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Korea
| | - DanHee Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyun Jin Lee
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
| | - Huong Vu
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hee-Jin Jeong
- Department of Bio and Chemical Engineering, HongIk University, Sejong-Si, Korea
| | - ByungGee Kim
- School of Chemical and Biological Engineering, Seoul National University, Seoul, Korea
| |
Collapse
|
21
|
Öztürk VÖ, Emingil G, Umeizudike K, Tervahartiala T, Gieselmann DR, Maier K, Köse T, Sorsa T, Alassiri S. Evaluation of active matrix metalloproteinase-8 (aMMP-8) chair-side test as a diagnostic biomarker in the staging of periodontal diseases. Arch Oral Biol 2021; 124:104955. [PMID: 33556789 DOI: 10.1016/j.archoralbio.2020.104955] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/05/2020] [Accepted: 10/11/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE There is a need for a reliable complementary diagnostic tool that ideally helps to screen, differentiate sites, activities of and predict future periodontal tissue destruction. The purpose of this cross-sectional study was to investigate the screening and prevention potential of the chair-side/point-of-care (PoC) diagnostic test of salivary active matrix metalloproteinase-8 (aMMP-8) levels at different stages of periodontal disease and periodontal health. MATERIAL & METHODS 80 individuals were included in this study; 18 with periodontitis stage 3 (P-Stage III), 19 with periodontitis stage-4 (P-Stage IV), 21 with gingivitis, and 22 with clinically healthy periodontium (H). The aMMP-8 levels in GCF and saliva were analyzed by chairside point-of-care aMMP-8 lateral flow immunotest and also by a time-resolved immunofluorescence assay (IFMA). RESULTS The sensitivity of the chair-side/PoC test was 83.9 % while specificity was 79.2 %. The aMMP-8 IFMA levels in GCF were significantly higher in P-Stage IV group than P-Stage III, gingivitis and healthy groups (p = 0.01, p = 0.001, p = 0.00, respectively). Moreover, P-Stage III and gingivitis groups had significantly higher aMMP-8 IFMA levels than the healthy group (p < 0.05). CONCLUSION The aMMP-8 chair-side test showed promising results in its ability to recognize and predict the inflammatory status even at the very initial/early stages. aMMP-8 chair-side test could be a valuable adjunctive diagnostic and preventive tool to conventional clinical methods in detecting periodontal disease.
Collapse
Affiliation(s)
- V Özgen Öztürk
- Department of Periodontology, School of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey.
| | - Gülnur Emingil
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Kehinde Umeizudike
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Idi-araba, Lagos, Nigeria
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Institute of Dentistry, Helsinki, Finland
| | - Dirk-Rolf Gieselmann
- Institute of Molecular Dentistry and Dentognostics GmbH, Solingen and Jena, Germany
| | - Kurt Maier
- Institute of Molecular Dentistry and Dentognostics GmbH, Solingen and Jena, Germany
| | - Timur Köse
- Department of Biostatistics and Medical Informatics, School of Medicine, Ege University, Izmir, Turkey
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Institute of Dentistry, Helsinki, Finland; Division of Oral Diseases, Department of Dental Medicine, Karolinksa Institute, Huddinge, Sweden
| | - Saeed Alassiri
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Institute of Dentistry, Helsinki, Finland
| |
Collapse
|
22
|
Räisänen IT, Sorsa T, Tervahartiala T, Raivisto T, Heikkinen AM. Low association between bleeding on probing propensity and the salivary aMMP-8 levels in adolescents with gingivitis and stage I periodontitis. J Periodontal Res 2020; 56:289-297. [PMID: 33305834 DOI: 10.1111/jre.12817] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Bleeding on probing (BOP) is a widely accepted measure used in periodontal diagnostics. Previous studies suggest that several factors can affect BOP propensity. The aim of this study was to investigate the relative impact of different local and modifying factors on BOP levels. MATERIALS AND METHODS The oral health of five hundred and forty-four adolescents (two birth cohorts) aged 15-17 years living in Kotka, Finland, was examined including periodontal probing depth, visible plaque index, root calculus, and BOP. Whole saliva samples were collected and measured for active matrix metalloproteinase-8 (aMMP-8) by time-resolved immunofluorometric assay (IFMA). RESULTS Bacterial plaque/calculus accumulation (oral hygiene) had a major influence on BOP levels. The relative impact was several times greater compared with the extent of periodontal pocketing, aMMP-8 levels, smoking, toothbrushing, or gender. Furthermore, BOP levels were significantly elevated among adolescents with poor oral hygiene than good oral hygiene even if adjusted for the extent of periodontal pocketing (P < .001). BOP levels could be low even if several ≥ 4 mm deep periodontal pockets existed. The difference in the extent of periodontal pocketing was not significant between the two birth cohorts of adolescents (P = .731). CONCLUSIONS BOP levels can be regarded as an important indicator of the extent of bacterial challenge and its adverse effects on the gingival inflammation. However, the level of oral hygiene may mask the association between the extent of gingival bleeding and the severity of the periodontal inflammatory condition. Thus, relying on BOP levels (below 10% or 20%) may provide insufficient information about the periodontal treatment need of an adolescent depending on his/her level of oral hygiene. Yet, more research is needed to confirm the results, also in adult populations.
Collapse
Affiliation(s)
- Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Teija Raivisto
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anna Maria Heikkinen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
23
|
Grigoriadis A, Räisänen IT, Pärnänen P, Tervahartiala T, Sorsa T, Sakellari D. Prediabetes/diabetes screening strategy at the periodontal clinic. Clin Exp Dent Res 2020; 7:85-92. [PMID: 33300692 PMCID: PMC7853879 DOI: 10.1002/cre2.338] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/06/2020] [Accepted: 09/08/2020] [Indexed: 01/20/2023] Open
Abstract
Objective The aim of the study was to propose an efficient chairside clinical strategy for the identification of undiagnosed hyperglycaemia in periodontal clinics. Material and methods Α chairside system was used for assessment of glycated hemoglobin 1c (HbA1c) and active Matrix Metalloproteinase‐8 levels (aMMP‐8) were analyzed by immunotest in patients (n = 150) who fulfilled the criteria for screening of the Centers for Disease Control and Prevention. Full‐mouth periodontal parameters were assessed and various data such as Body Mass Index (BMI), smoking and education were recorded. Results Thirty‐one patients out of 150 tested were found with unknown hyperglycaemia (20.7%). Regarding sex, education, parent with diabetes, normal BMI, smoking, age ≥45 years and prior testing for diabetes, no differences were observed between subjects displaying HbA1c < 5.7 and ≥5.7% (Pearson's Chi‐square test, p > .05). Subgroups differed regarding BMI (kg/m2), tooth count, percentages of 4 and 5 mm pockets (Mann–Whitney and z‐test, p < .05). The diagnostic performance for HbA1c ≥5.7 was tested by Receiving Operator Characteristic curves and Areas Under the Curve (AUC) for the following: age ≥ 45 years and BMI (AUC 0.651, p = .010), the above and aMMP‐8 (AUC 0.660, p = .006), age ≥ 45 years, BMI and Stage of Periodontitis (AUC 0.711, p < .001) and age ≥ 45 years, BMI, aMMP‐8 and stage of periodontitis (AUC 0.713, p < .001). Conclusions Findings of the study suggest that the combination of stage of periodontitis, increasing age, BMI and aMMP‐8, without chairside HbA1c assessment appears to be a viable screening strategy for referring dental patients for testing for prediabetes/diabetes.
Collapse
Affiliation(s)
- Andreas Grigoriadis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece.,424 General Military Training Hospital, Thessaloniki, Greece
| | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
24
|
Gul SS, Abdulkareem AA, Sha AM, Rawlinson A. Diagnostic Accuracy of Oral Fluids Biomarker Profile to Determine the Current and Future Status of Periodontal and Peri-Implant Diseases. Diagnostics (Basel) 2020; 10:diagnostics10100838. [PMID: 33081038 PMCID: PMC7603129 DOI: 10.3390/diagnostics10100838] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/10/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023] Open
Abstract
Severe periodontitis is ranked as the sixth most prevalent disease affecting humankind, with an estimated 740 million people affected worldwide. The diagnosis of periodontal diseases mainly relies upon assessment of conventional clinical parameters. However, these parameters reflect past, rather than current, clinical status or future disease progression and, likely, outcome of periodontal treatment. Specific and sensitive biomarkers for periodontal diseases have been examined widely to address these issues and some biomarkers have been translated as point-of-care (PoC) tests. The aim of this review was to provide an update on PoC tests for use in the diagnosis and management of periodontal diseases. Among the PoC tests developed so far, active matrix metalloproteinase-8 has shown promising results in terms of diagnostic and prognostic values. However, further studies are required to increase the sensitivity and specificity via combining more than one biomarker and merging these test kits with periodontal risk assessment tools. Furthermore, the validity of these test kits needs to be investigated by applying the results in further independent studies and the impact on these test kits’, together with the results of risk factors for periodontal diseases, such as diabetes and smoking, also needs to be examined.
Collapse
Affiliation(s)
- Sarhang S. Gul
- College of Dentistry, Periodontics Department, University of Sulaimani, Sulaymaniyah 1124–30, Iraq;
- Correspondence: ; Tel.: +964-7701-447-723
| | - Ali A. Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad 10011, Iraq;
| | - Aram M. Sha
- College of Dentistry, Periodontics Department, University of Sulaimani, Sulaymaniyah 1124–30, Iraq;
| | - Andrew Rawlinson
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK;
| |
Collapse
|
25
|
Räisänen IT, Umeizudike KA, Pärnänen P, Heikkilä P, Tervahartiala T, Nwhator SO, Grigoriadis A, Sakellari D, Sorsa T. Periodontal disease and targeted prevention using aMMP-8 point-of-care oral fluid analytics in the COVID-19 era. Med Hypotheses 2020; 144:110276. [PMID: 33254580 PMCID: PMC7492808 DOI: 10.1016/j.mehy.2020.110276] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/02/2020] [Accepted: 09/12/2020] [Indexed: 02/06/2023]
Abstract
Periodontal disease is a chronic multifactorial infectious and inflammatory disease associated with several chronic systemic diseases, such as diabetes, cardiovascular diseases (CVD), chronic obstructive pulmonary disease, hypertension, Alzheimer’s disease and so on. These same systemic diseases have been associated with severe COVID-19 infections. Several recent studies have suggested hypotheses for the potential association between periodontal disease and severe COVID-19. Periodontal disease is also one of the most prevalent diseases globally. All this supports the importance of good oral health, also in the COVID-19 era. Thus, new strategies and approaches to identify patients at risk of periodontal disease could be beneficial to enhance secondary prevention, especially if targeted to COVID-19 risk groups. Diagnostic biomarkers for periodontal disease have been researched extensively. Potential biomarkers in oral fluid with currently available rapid non-invasive point-of-care technology, such as aMMP-8, could help to extend screening and identification of patients at risk for periodontal disease also to situations and places where professional dental expertise and equipment are limited or unavailable. i.e., nursing and care homes, and rural and distant places. The oral fluid point-of-care technologies could also be useful in the hands of medical professionals (diabetes, CVD, etc.) to identify patients at risk for undiagnosed periodontal disease and to refer them to a dentist for examination and evaluation. Finally, if there is a causality between periodontal disease and severe COVID-19 infections, these point-of-care oral fluid biomarker technologies could possibly also help in the assessment of the risk of deterioration and complications.
Collapse
Affiliation(s)
- Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland.
| | - Kehinde A Umeizudike
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland
| | - Pia Heikkilä
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland
| | - Solomon O Nwhator
- Department of Preventive and Community Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Andreas Grigoriadis
- Department of Periodontology, 424 General Army Hospital, Thessaloniki, Greece; Department of Preventive Dentistry, Periodontology, and Implant Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology, and Implant Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland; Department of Oral Diseases, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
26
|
Lähteenmäki H, Umeizudike KA, Heikkinen AM, Räisänen IT, Rathnayake N, Johannsen G, Tervahartiala T, Nwhator SO, Sorsa T. aMMP-8 Point-of-Care/Chairside Oral Fluid Technology as a Rapid, Non-Invasive Tool for Periodontitis and Peri-Implantitis Screening in a Medical Care Setting. Diagnostics (Basel) 2020; 10:diagnostics10080562. [PMID: 32764436 PMCID: PMC7460514 DOI: 10.3390/diagnostics10080562] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/18/2020] [Accepted: 08/04/2020] [Indexed: 12/14/2022] Open
Abstract
This communication article addresses currently available rapid non-invasive methods to screen and detect periodontitis and dental peri-implantitis. In this regard, oral fluid biomarkers have been researched extensively but self-reported oral health (SROH)-questionnaires have also been developed. Both alternatives may offer a quick and easy way to screen and detect diseased patients. Active matrix metalloproteinase (aMMP-8) is one of the most validated biomarkers for screening and detecting periodontal breakdown related to periodontitis and peri-implantitis and monitoring their treatment effects revealing successful, less- and non-successful treatment results. Currently available aMMP-8 lateral-flow technologies allow this kind of analysis, as demonstrated here, to be conducted quantitatively online and real-time as point-of-care/chairside testing in dental and even medical care settings. In this study, an aMMP-8 peri-implant sulcular fluid point-of-care-test diagnosed peri-implantitis and healthy implants far more accurately than bleeding-on-probing or the other biomarkers, such as polymorphonuclear (PMN)/neutrophil elastase, myeloperoxidase and MMP-9. Although, SROH-questionnaires allow screening in similar settings but they lack the information about the current disease activity of periodontitis and peri-implantitis, which is of essential value in periodontal diagnostics and treatment monitoring. Thus, both methods can be considered as adjunct methods for periodontitis and peri-implant diagnostics, but the value of oral fluid biomarkers analysis does not seem to be substitutable.
Collapse
Affiliation(s)
- Hanna Lähteenmäki
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, PO Box 63 (Haartmaninkatu 8), FI-00014 Helsinki, Finland; (H.L.); (A.M.H.); (N.R.); (T.T.); (T.S.)
| | - Kehinde A. Umeizudike
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos 100213, Nigeria;
| | - Anna Maria Heikkinen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, PO Box 63 (Haartmaninkatu 8), FI-00014 Helsinki, Finland; (H.L.); (A.M.H.); (N.R.); (T.T.); (T.S.)
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, PO Box 63 (Haartmaninkatu 8), FI-00014 Helsinki, Finland; (H.L.); (A.M.H.); (N.R.); (T.T.); (T.S.)
- Correspondence:
| | - Nilminie Rathnayake
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, PO Box 63 (Haartmaninkatu 8), FI-00014 Helsinki, Finland; (H.L.); (A.M.H.); (N.R.); (T.T.); (T.S.)
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden;
| | - Gunnar Johannsen
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden;
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, PO Box 63 (Haartmaninkatu 8), FI-00014 Helsinki, Finland; (H.L.); (A.M.H.); (N.R.); (T.T.); (T.S.)
| | - Solomon O. Nwhator
- Department of Preventive & Community Dentistry, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife A234, Nigeria;
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, PO Box 63 (Haartmaninkatu 8), FI-00014 Helsinki, Finland; (H.L.); (A.M.H.); (N.R.); (T.T.); (T.S.)
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden;
| |
Collapse
|
27
|
Karteva T, Manchorova-Veleva N. Biomarker for Asymptomatic Apical Periodontitis in Gingival Crevicular Fluid: aMMP-8. Eur J Dent 2020; 14:239-244. [PMID: 32396973 PMCID: PMC7274820 DOI: 10.1055/s-0040-1709827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objectives
Asymptomatic apical periodontitis (AAP) is one of the most widespread chronic inflammatory diseases in the field of dental medicine. Active matrix metalloproteinase (aMMP-8) previously demonstrated diagnostic potential as a biomarker for AAP in gingival crevicular fluid (GCF). The aim of this study was to determine the levels and diagnostic accuracy of aMMP-8 in GCF from teeth with AAP.
Materials and Methods
In this cross-sectional study, GCF samples were obtained from teeth with AAP (sample group,
n
= 31) and their contralateral teeth (control group,
n
= 31). Clinical and cone beam computed tomography (CBCT) parameters were used for the diagnosis and assessment of AAP and the determination of clinically healthy marginal periodontal tissues. One pool GCF sample per tooth was obtained from the whole crevice’s perimeter. aMMP-8 levels were determined by enzyme-linked immunosorbent assay (ELISA).
Statistical Analysis
Wilcoxon signed ranks test and Spearman rank correlation coefficient (rs) were used as statistical tools. The significance level was set at
p
< .05.
Results
The two groups demonstrated biomarker levels corresponding to a healthy marginal periodontal tissue. aMMP-8 levels were statistically and significantly higher in the samples collected from teeth with AAP. Lesions with greater volume showed correspondingly larger diameters. No statistically significant correlation between aMMP-8 levels and lesions’ volume or diameter was discovered.
Conclusion
GCF composition is modified by AAP only to a minimal extent. Further research is needed to substantiate the utilization of aMMP-8 as a potential biomarker for the diagnosis of the disease as well as to explore its relationship with other biomarkers.
Collapse
Affiliation(s)
- Teodora Karteva
- Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Medical University - Plovdiv, Plovdiv, Bulgaria
| | - Neshka Manchorova-Veleva
- Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Medical University - Plovdiv, Plovdiv, Bulgaria
| |
Collapse
|
28
|
Sorsa T, Alassiri S, Grigoriadis A, Räisänen IT, Pärnänen P, Nwhator SO, Gieselmann DR, Sakellari D. Active MMP-8 (aMMP-8) as a Grading and Staging Biomarker in the Periodontitis Classification. Diagnostics (Basel) 2020; 10:diagnostics10020061. [PMID: 31979091 PMCID: PMC7168924 DOI: 10.3390/diagnostics10020061] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 12/16/2022] Open
Abstract
The aim of this study was to investigate the utility of incorporating active matrix metalloproteinase-8 (aMMP-8) as a biomarker into the new periodontitis classification system (stage/grade) presented in 2018. This study included 150 Greek adults aged 25-78, of whom 74 were men and 76 women. Participants were tested with an aMMP-8 point-of-care mouthrinse test, after which a full-mouth clinical examination was performed to assess their periodontal and oral health. The aMMP-8 levels in mouthrinse were significantly lower among healthy patients compared with patients in more severe periodontitis stages and grades (Kruskal-Wallis test and Dunn-Bonferroni test for pairwise post-hoc comparisons; p < 0.01 and p < 0.05, respectively). Furthermore, aMMP-8 levels were less correlated with plaque levels than bleeding on probing (BOP) (Spearman's rho = 0.269, p < 0.001; Spearman's rho = 0.586, p < 0.001); respectively). Thus, aMMP-8 was more robust to the confounding effects of oral hygiene than traditional periodontal parameter bleeding on probing. The aMMP-8 point-of-care mouthrinse test can be utilized as an adjunctive and preventive diagnostic tool to identify periodontal disease, classified by stage and grade, and ongoing periodontal breakdown chairside in clinical practice in only 5 min. Overall, integrating aMMP-8 into the new periodontitis classification system seems beneficial.
Collapse
Affiliation(s)
- Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8) FI-00014, 00100 Helsinki, Finland
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- Correspondence: (T.S.); (I.T.R.)
| | - Saeed Alassiri
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8) FI-00014, 00100 Helsinki, Finland
| | - Andreas Grigoriadis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- 424 General Army Hospital, 54124 Thessaloniki, Greece
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8) FI-00014, 00100 Helsinki, Finland
- Correspondence: (T.S.); (I.T.R.)
| | - Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8) FI-00014, 00100 Helsinki, Finland
| | - Solomon O. Nwhator
- Department of Preventive & Community Dentistry, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife 220104, Osun State, Nigeria
| | - Dirk-Rolf Gieselmann
- Institute for Molecular Diagnostics (IMOD), Bonner Str. 84, 42697 Solingen, Germany
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| |
Collapse
|
29
|
Silbereisen A, Alassiri S, Bao K, Grossmann J, Nanni P, Fernandez C, Tervahartiala T, Nascimento GG, Belibasakis GN, Heikkinen A, Lopez R, Sorsa T, Bostanci N. Label‐Free Quantitative Proteomics versus Antibody‐Based Assays to Measure Neutrophil‐Derived Enzymes in Saliva. Proteomics Clin Appl 2020; 14:e1900050. [DOI: 10.1002/prca.201900050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/20/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Angelika Silbereisen
- Section of Periodontology and Dental Prevention Division of Oral Diseases Department of Dental Medicine Karolinska Institutet Alfred Nobels allé 8 14152 Huddinge Stockholm Sweden
| | - Saeed Alassiri
- Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki University Central Hospital P.O. Box 41 (Mannerheimintie 172) 00014 Helsinki Finland
| | - Kai Bao
- Section of Periodontology and Dental Prevention Division of Oral Diseases Department of Dental Medicine Karolinska Institutet Alfred Nobels allé 8 14152 Huddinge Stockholm Sweden
| | - Jonas Grossmann
- Functional Genomics Center Zurich ETH Zurich and University of Zurich Winterthurerstrasse 190 8057 Zurich Switzerland
| | - Paolo Nanni
- Functional Genomics Center Zurich ETH Zurich and University of Zurich Winterthurerstrasse 190 8057 Zurich Switzerland
| | - Claudia Fernandez
- Functional Genomics Center Zurich ETH Zurich and University of Zurich Winterthurerstrasse 190 8057 Zurich Switzerland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki University Central Hospital P.O. Box 41 (Mannerheimintie 172) 00014 Helsinki Finland
| | - Gustavo G. Nascimento
- Section of Periodontology Department of Dentistry and Oral Health Aarhus University Vennelyst Boulevard 9 8000 Aarhus C Denmark
| | - Georgios N. Belibasakis
- Section of Periodontology and Dental Prevention Division of Oral Diseases Department of Dental Medicine Karolinska Institutet Alfred Nobels allé 8 14152 Huddinge Stockholm Sweden
| | - Anna‐Maria Heikkinen
- Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki University Central Hospital P.O. Box 41 (Mannerheimintie 172) 00014 Helsinki Finland
| | - Rodrigo Lopez
- Section of Periodontology Department of Dentistry and Oral Health Aarhus University Vennelyst Boulevard 9 8000 Aarhus C Denmark
| | - Timo Sorsa
- Section of Periodontology and Dental Prevention Division of Oral Diseases Department of Dental Medicine Karolinska Institutet Alfred Nobels allé 8 14152 Huddinge Stockholm Sweden
- Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki University Central Hospital P.O. Box 41 (Mannerheimintie 172) 00014 Helsinki Finland
| | - Nagihan Bostanci
- Section of Periodontology and Dental Prevention Division of Oral Diseases Department of Dental Medicine Karolinska Institutet Alfred Nobels allé 8 14152 Huddinge Stockholm Sweden
| |
Collapse
|
30
|
On the diagnostic discrimination ability of mouthrinse and salivary aMMP-8 point-of-care testing regarding periodontal health and disease. Diagn Microbiol Infect Dis 2019; 95:114871. [DOI: 10.1016/j.diagmicrobio.2019.114871] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 07/18/2019] [Accepted: 07/20/2019] [Indexed: 01/27/2023]
|
31
|
Räisänen IT, Heikkinen AM, Pakbaznejad Esmaeili E, Tervahartiala T, Pajukanta R, Silbereisen A, Bostanci N, Sorsa T. A point‐of‐care test of active matrix metalloproteinase‐8 predicts triggering receptor expressed on myeloid cells‐1 (TREM‐1) levels in saliva. J Periodontol 2019; 91:102-109. [DOI: 10.1002/jper.19-0132] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/16/2019] [Accepted: 05/15/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Ismo T. Räisänen
- Department of Oral and Maxillofacial DiseasesHead and Neck CenterUniversity of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Anna Maria Heikkinen
- Department of Oral and Maxillofacial DiseasesHead and Neck CenterUniversity of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Elmira Pakbaznejad Esmaeili
- Department of Oral and Maxillofacial DiseasesHead and Neck CenterUniversity of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial DiseasesHead and Neck CenterUniversity of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Riitta Pajukanta
- Department of Oral and Maxillofacial DiseasesHead and Neck CenterUniversity of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Angelika Silbereisen
- Section of Periodontology and Dental PreventionDivision of Oral DiseasesDepartment of Dental MedicineKarolinska Institutet Huddinge Sweden
| | - Nagihan Bostanci
- Section of Periodontology and Dental PreventionDivision of Oral DiseasesDepartment of Dental MedicineKarolinska Institutet Huddinge Sweden
| | - Timo Sorsa
- Department of Oral and Maxillofacial DiseasesHead and Neck CenterUniversity of Helsinki and Helsinki University Hospital Helsinki Finland
- Section of Periodontology and Dental PreventionDivision of Oral DiseasesDepartment of Dental MedicineKarolinska Institutet Huddinge Sweden
| |
Collapse
|
32
|
Schmalz G, Hübscher AE, Angermann H, Schmidt J, Schmickler J, Legler TJ, Ziebolz D. Associations of chairside salivary aMMP-8 findings with periodontal parameters, potentially periodontal pathogenic bacteria and selected blood parameters in systemically healthy adults. Diagn Microbiol Infect Dis 2019; 95:179-184. [PMID: 31174997 DOI: 10.1016/j.diagmicrobio.2019.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/30/2019] [Accepted: 05/04/2019] [Indexed: 12/19/2022]
Abstract
The aim of this cross-sectional study was to investigate associations between salivary active matrix-metalloproteinase 8 (aMMP-8) and periodontitis severity, potentially periodontal pathogenic bacteria as well as blood parameters in generally healthy participants. Therefore, 188 participants with a mean age of 48.9 ± 8 years were examined. The periodontitis severity was assessed based on periodontal probing depth and clinical attachment loss. Both, aMMP-8 and microbiological analysis were performed using a validated, commercially available test system. Blood values were utilized from regular differential blood count. The aMMP-8 findings were associated with the periodontitis severity (P < 0.01), as well as with the prevalence of Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Parvimonas micra, Camphylobacter rectus and Eubacterium nodatum (Pi < 0.05). No associations between aMMP-8 and the examined blood parameters were found (Pi > 0.05). In conclusion, salivary aMMP-8 findings seem to reflect periodontal disease severity as a result of an immunoreaction, especially against bacteria with high periodontal pathogenic potential.
Collapse
Affiliation(s)
- Gerhard Schmalz
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Anna Elisabeth Hübscher
- Dept. of Preventive Dentistry, Periodontology and Cariology, University Medical Centre Goettingen, Germany
| | - Helena Angermann
- Dept. of Preventive Dentistry, Periodontology and Cariology, University Medical Centre Goettingen, Germany
| | - Jana Schmidt
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Jan Schmickler
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Tobias J Legler
- Department of Transfusion Medicine, University Medical Centre Goettingen, Germany
| | - Dirk Ziebolz
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany.
| |
Collapse
|
33
|
Räisänen IT, Sorsa T, van der Schoor GJ, Tervahartiala T, van der Schoor P, Gieselmann DR, Heikkinen AM. Active Matrix Metalloproteinase-8 Point-of-Care (PoC)/Chairside Mouthrinse Test vs. Bleeding on Probing in Diagnosing Subclinical Periodontitis in Adolescents. Diagnostics (Basel) 2019; 9:diagnostics9010034. [PMID: 30909530 PMCID: PMC6468891 DOI: 10.3390/diagnostics9010034] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 03/16/2019] [Accepted: 03/21/2019] [Indexed: 11/16/2022] Open
Abstract
This cross-sectional study compares the effectiveness of an active MMP-8 (aMMP-8) point-of-care (PoC)/chairside mouthrinse test to the conventional bleeding on probing (BOP) (cutoff 20%) test in detecting subclinical periodontitis/pre-periodontitis in Finnish adolescents. The study was carried out at the Kotka Health Center, Finland. A total of 47 adolescents (30 boys/17 girls) aged 15–17 were first tested with the aMMP-8 PoC test, followed by a full-mouth evaluation of clinical parameters of oral health including periodontal, oral mucosal, and caries assessment. A periodontist performed these clinical examinations. The aMMP-8 PoC test result had much stronger association with subclinical periodontitis than the BOP 20% test (2.8–5.3 times stronger in terms of odds ratio). The aMMP-8 PoC test had ≥2 times higher sensitivity than the BOP 20% test with, generally, the same specificity. Further, the aMMP-8 PoC test had generally better accuracy and lower false negative percentages. The aMMP-8 PoC test seemed to be more effective than the conventional BOP test in detecting subclinical periodontitis/pre-periodontitis in adolescents reducing the risk of their undertreatment. However, the sample size may be a limiting factor, and more studies are needed to confirm our results for both adolescents and adults.
Collapse
Affiliation(s)
- Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8), 00014 Helsinki, Finland.
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8), 00014 Helsinki, Finland.
- Division of Periodontology, Department of Dental Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden.
| | - Gerrit-Jan van der Schoor
- Division of Periodontology, Department of Dental Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden.
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8), 00014 Helsinki, Finland.
| | - Peter van der Schoor
- Division of Periodontology, Department of Dental Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden.
| | - Dirk-Rolf Gieselmann
- Institute for Molecular Diagnostics (IMOD), Bonner Str. 84, 42697 Solingen, Germany.
| | - Anna Maria Heikkinen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8), 00014 Helsinki, Finland.
| |
Collapse
|
34
|
Point-of-Care/Chairside aMMP-8 Analytics of Periodontal Diseases' Activity and Episodic Progression. Diagnostics (Basel) 2018; 8:diagnostics8040074. [PMID: 30360358 PMCID: PMC6315514 DOI: 10.3390/diagnostics8040074] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/15/2018] [Accepted: 10/18/2018] [Indexed: 12/27/2022] Open
Abstract
Traditional periodontal disease diagnostics are based mainly on clinical examination and radiographs. They assess only past tissue destruction and provide no information on the current disease status or its future progression. The objective is to find out if an active matrix metalloproteinase-8 (aMMP-8) point-of-care (PoC) test could provide a cost-effective way to get around this limitation. This cross-sectional study used 47 adolescents and 70 adults, who were clinically examined and their aMMP-8 PoC tested. The aMMP-8 PoC test results and patients’ treatment need, based on the community periodontal index of treatment needs (CPITN), were compared and analyzed using Fisher’s exact test. In terms of CPITN, the aMMP-8 PoC test gave no false positives for both adolescents and adults. All healthy patients got a negative test result, while a positive test result indicated periodontal treatment need correctly. Finally, there was a significant association between a patient’s aMMP-8 PoC test result and his/her treatment need (p = 0.001 for adolescents, p = 0.001 for adults). In conclusion, more accurate diagnostics of periodontal diseases’ activity and progression using an aMMP-8 PoC test may help to reduce oral health care costs by reducing patient overtreatment, improving patient outcome, and reducing the need for complex periodontal therapy.
Collapse
|
35
|
Leppilahti JM, Harjunmaa U, Järnstedt J, Mangani C, Hernández M, Tervahartiala T, Lopez R, Ashorn U, Ashorn P, Gieselmann DR, Sorsa T. Diagnosis of Newly Delivered Mothers for Periodontitis with a Novel Oral-Rinse aMMP-8 Point-of-Care Test in a Rural Malawian Population. Diagnostics (Basel) 2018; 8:diagnostics8030067. [PMID: 30223547 PMCID: PMC6164346 DOI: 10.3390/diagnostics8030067] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 12/28/2022] Open
Abstract
A novel qualitative point-of-care test of activated matrix metalloproteinase-8 (aMMP-8) using noninvasive oral rinse sampling procedures has been developed for the early detection of collagen breakdown indicating periodontal tissue destruction. The main object of this study was to assess the reliability of the test in a low-income setting to identify participants with history of periodontal destruction detected as alveolar bone loss (ABL) in radiographs. This cross-sectional study included 486 women who had recently delivered in rural Malawi. The aMMP-8 test and dental panoramic radiographs were taken within 48 h of delivery. The performance of the test in comparison to radiological examinations was tested by following the standards for reporting of diagnostic accuracy studies protocol (STARD) with respective statistical measures and 95% confidence intervals. From the 486 eligible participants, 461 mothers with complete data, aged from 15 to 46 years (mean 24.8, SD 6.0) were included in the analysis. ABL was identified in 116 of 461 participants. There was 56% agreement between the aMMP-8 test results and detected ABL (yes or no) in radiographs. Calculated sensitivity of the test was 80% (72–87%), specificity 48% (43–54%), positive predictive value 34% (31–37%), negative predictive value 88% (83–91%), positive likelihood ratio 1.55 (1.35–1.77), and negative likelihood ratio 0.41(0.28–0.60). The aMMP-8 test sensitivity and negative predictive value to identify the ABL cases were relatively high, but there was additionally a high rate of test-positive results in participants without ABL, especially in young mothers, leading to low overall agreement between the test results and radiological bone loss. Further longitudinal studies are needed to examine if the test positive subjects are in risk of future bone loss before the detectable signs of periodontitis in radiographs.
Collapse
Affiliation(s)
- Jussi M Leppilahti
- Department of Periodontology and Geriatric Dentistry, University of Oulu, Oulu 90014, Finland.
| | - Ulla Harjunmaa
- Center for Child Health Research, University of Tampere, Tampere 33014, Finland.
| | - Jorma Järnstedt
- Center for Child Health Research, University of Tampere, Tampere 33014, Finland.
| | - Charles Mangani
- College of Medicine, University of Malawi, Private Bag 360, Chichiri, Blantyre, Malawi.
| | - Marcela Hernández
- Laboratory of Periodontal Biology and Department of Pathology and Oral Medicine, Faculty of Dentistry, Universidad de Chile, Av. Sergio Livingstone Polhammer 943, Independencia, Santiago 8380492, Chile.
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Stenbäckinkatu 9, PO BOX 100, Helsinki 00029, Finland.
| | - Rodrigo Lopez
- Department of Dentistry and Oral Health, Aarhus University, Faculty of Health Sciences Aarhus University Vennelyst Boulevard 9, Aarhus 8000, Denmark.
| | - Ulla Ashorn
- Center for Child Health Research, University of Tampere, Tampere 33014, Finland.
| | - Per Ashorn
- Department of Paediatrics, Tampere University Hospital Central Hospital PO BOX 2000, Tampere 33521, Finland.
| | - Dirk-Rolf Gieselmann
- Institute for Molecular Diagnostics (IMOD), Bonner Str. 84, Solingen 42697, Germany.
| | - Timo Sorsa
- Division of Periodontology, Department of Dental Medicine, Karolinska Institute, Stockholm SE-171 77, Sweden.
| |
Collapse
|
36
|
Wu YC, Ning L, Tu YK, Huang CP, Huang NT, Chen YF, Chang PC. Salivary biomarker combination prediction model for the diagnosis of periodontitis in a Taiwanese population. J Formos Med Assoc 2018; 117:841-848. [DOI: 10.1016/j.jfma.2017.10.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 10/02/2017] [Accepted: 10/16/2017] [Indexed: 11/15/2022] Open
|
37
|
Schmalz G, Kummer MK, Kottmann T, Rinke S, Haak R, Krause F, Schmidt J, Ziebolz D. Association of chairside salivary aMMP-8 findings with periodontal risk assessment parameters in patients receiving supportive periodontal therapy. J Periodontal Implant Sci 2018; 48:251-260. [PMID: 30202608 PMCID: PMC6125668 DOI: 10.5051/jpis.2018.48.4.251] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/20/2018] [Indexed: 01/22/2023] Open
Abstract
Purpose The aim of this retrospective cross-sectional study was to evaluate whether salivary findings of active matrix-metalloproteinase 8 (aMMP-8) chairside (point of care; POC) tests were associated with periodontal risk assessment parameters in patients receiving supportive periodontal therapy (SPT). Methods A total of 125 patients receiving regular SPT were included, and their records were examined. The following inclusion criteria were used: a diagnosis of chronic periodontitis, at least 1 non-surgical periodontal treatment (scaling and root planning) with following regular SPT (minimum once a year), at least 6 remaining teeth, and clinical and aMMP-8 findings that were obtained at the same appointment. In addition to anamnestic factors (e.g., smoking and diabetes), oral hygiene indices (modified sulcus bleeding index [mSBI] and approximal plaque index), periodontal probing depth simultaneously with bleeding on probing, and dental findings (number of decayed, missing, and filled teeth) were recorded. Salivary aMMP-8 levels were tested using a commercial POC test system (Periomarker, Hager & Werken, Duisburg, Germany). Statistical analysis was performed using the t-test, Mann-Whitney U test, Fisher's exact test, and χ2 test, as appropriate (P<0.05). Results Only the mSBI was significantly associated with positive salivary aMMP-8 findings (aMMP-8 positive: 27.8%±20.9% vs. aMMP-8 negative: 18.0%±14.5%; P=0.017). No significant associations were found between aMMP-8 and smoking, diabetes, periodontal parameters, or parameters related to the maintenance interval (P>0.05). Conclusions Salivary aMMP-8 chairside findings were not associated with common parameters used for periodontal risk assessment in patients receiving SPT. The diagnostic benefit of POC salivary aMMP-8 testing in risk assessment and maintenance interval adjustment during SPT remains unclear.
Collapse
Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Max Kristian Kummer
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | | | - Sven Rinke
- Dental Practice, Hanau & Alzenau, Germany.,Department of Prosthodontics, University Medical Center Goettingen, Goettingen, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Felix Krause
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Jana Schmidt
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| |
Collapse
|
38
|
The Ability of Quantitative, Specific, and Sensitive Point-of-Care/Chair-Side Oral Fluid Immunotests for aMMP-8 to Detect Periodontal and Peri-Implant Diseases. DISEASE MARKERS 2018; 2018:1306396. [PMID: 30154936 PMCID: PMC6098860 DOI: 10.1155/2018/1306396] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/21/2018] [Indexed: 01/16/2023]
Abstract
The analysis of the disease-specific oral and systemic biomarkers in saliva and oral fluids (i.e., mouth rinse, gingival crevicular fluid (GCF), and peri-implantitis fluid (PISF)) is demanding. Several hosts and microbial factors may influence their expression, release, and levels. The type of saliva/oral fluids utilized for the diagnostics affects the analysis. High sensitivity and specificities together with sophisticated methods and techniques are essential for valuable outcome. We describe here recently developed practical, convenient, inexpensive, noninvasive, and quantitative mouth rinse and PISF/GCF/chair-side/point-of-care (PoC) lateral-flow aMMP-8 immunoassays (PerioSafe and ImplantSafe/ORALyser) to detect, predict, and monitor successfully the course, treatment, and prevention of periodontitis and peri-implantitis, respectively. The tests have been independently and successfully validated to differentiate periodontal and peri-implant health and disease in Finland, Germany, Netherland, Sweden, Turkey, Nigeria, Malawi, and USA. The clinical use of salivary/oral fluid biomarkers to identify oral and systemic conditions requires additional studies utilizing these noninvasive screening, diagnostic, and preventive aMMP-8 PoC/chair-side technologies.
Collapse
|
39
|
Mauramo M, Ramseier AM, Mauramo E, Buser A, Tervahartiala T, Sorsa T, Waltimo T. Associations of oral fluid MMP-8 with periodontitis in Swiss adult subjects. Oral Dis 2017; 24:449-455. [PMID: 28889479 DOI: 10.1111/odi.12769] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 08/06/2017] [Accepted: 08/22/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE MMP-8 is a prominent collagenase in periodontal disease. This cross-sectional study examined whether MMP-8 levels in saliva and gingival crevicular fluid (GCF) are associated with periodontitis in a Swiss population. SUBJECTS AND METHODS A total of 258 subjects (107 m, 151 f, mean age: 43.5 yr; range: 21-58 yr) acquired from the Swiss bone marrow donor registry participated in the study. Saliva and GCF samples were collected from subjects followed by a thorough dental and periodontal examination. MMP-8 levels were determined with immunofluorometric assay. Associations of MMP-8 levels with periodontal diagnosis, probing pocket depth (PPD) and bleeding on probing were statistically analysed with Pearson chi-square test, Spearman's rho and logistic regression analysis. RESULTS MMP-8 in GCF correlated with MMP-8 in saliva (p < .001). Periodontitis was more common (p < .001) among subjects with high levels of MMP-8 in saliva and/or GCF compared with subjects with low levels of MMP-8. Higher MMP-8 levels in GCF and saliva were associated with any periodontal diagnosis (mild, moderate or severe), greater PPD, and bleeding on probing (p < .05). When age, gender, smoking, body mass index, number of medications and decayed, missing and filled teeth were adjusted for, all observed associations remained statistically significant. The area under curve of receiver-operating characteristic was 0.67 for saliva and 0.71 for GCF. CONCLUSION Elevated MMP-8 levels both in saliva and GCF are associated with periodontitis in a normal adult population.
Collapse
Affiliation(s)
- M Mauramo
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Pathology, Haartman Institute and HUSLab, Helsinki University Central Hospital, Helsinki, Finland
| | - A M Ramseier
- Department of Preventive Dentistry and Oral Microbiology, School of Dental Medicine, University of Basel, Basel, Switzerland
| | - E Mauramo
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - A Buser
- The Blood Transfusion Service SRC Basel, Basel, Switzerland
| | - T Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - T Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - T Waltimo
- Department of Preventive Dentistry and Oral Microbiology, School of Dental Medicine, University of Basel, Basel, Switzerland
| |
Collapse
|
40
|
Sorsa T, Gieselmann D, Arweiler NB, Hernández M. A quantitative point-of-care test for periodontal and dental peri-implant diseases. Nat Rev Dis Primers 2017; 3:17069. [PMID: 28905941 DOI: 10.1038/nrdp.2017.69] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | | | - Nicole B Arweiler
- Department of Periodontology, Philipps University of Marburg, Marburg, Germany
| | - Marcela Hernández
- Laboratory of Periodontal Biology and Department of Oral Pathology and Medicine, Faculty of Dentistry, Universidad de Chile, Av. Sergio Livingstone Polhammer 943, Independencia, Santiago 8380492, Chile.,Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, El Llano Subercaseaux 2801, San Miguel Santiago 8910060, Chile
| |
Collapse
|