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
|
Tortolini C, Gigli V, Angeloni A, Tasca F, Thanh NTK, Antiochia R. A disposable immunosensor for the detection of salivary MMP-8 as biomarker of periodontitis. Bioelectrochemistry 2024; 156:108590. [PMID: 37976772 DOI: 10.1016/j.bioelechem.2023.108590] [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: 05/19/2023] [Revised: 09/08/2023] [Accepted: 10/20/2023] [Indexed: 11/19/2023]
Abstract
This work describes the development of a novel voltammetric immunosensor for the detection of salivary MMP-8 at the point-of-care. The electrochemical platform was based on a graphene (GPH) screen-printed electrode (SPE) functionalized by gold-nanospheres (AuNSs) and antibodies against MMP-8 protein (anti-MMP-8). The functionalization with anti-MMP-8 was realized by using 11-mercaptoundecanoic acid (11-MUA), thanks to its ability to give strong sulfur bonds with its -SH end, and to cross-link the -NH2 groups of the antibody molecule with the other -COOH end, using the traditional EDC-NHS method. The voltammetric sensor showed good performances with a linear range of 2.5-300 ng mL-1, a LOD value of 1.0 ± 0.1 ng mL-1 and a sensitivity of 0.05 µA mL cm-2 ng-1. Moreover, the proposed immunosensor was tested in real saliva samples, showing comparable results to those obtained with the conventional ELISA method. The biosensor was single-use and cost-effective and required a small quantity of test medium and a short preparation time, representing a very attractive biosensor for MMP-8 detection in human saliva.
Collapse
Affiliation(s)
- Cristina Tortolini
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Valeria Gigli
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Antonio Angeloni
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Federico Tasca
- Faculty of Chemistry and Biology, Department of Materials Chemistry, University of Santiago of Chile, Av. Libertador Bernardo ÓHiggins 3363, 8320000 Estacion Central, Santiago, Chile
| | - Nguyen T K Thanh
- Biophysics Group, Department of Physics & Astronomy, University College London, Gower Street, London WC1E 6BT, UK; UCL Healthcare Biomagnetic and Nanomaterials Laboratories, Royal Institution of Great Britain, 21 Albermarle Street, London W1S 4BS, UK
| | - Riccarda Antiochia
- Department of Chemistry and Drug Technologies, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy.
| |
Collapse
|
3
|
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
|
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
|
Molecular Basis beyond Interrelated Bone Resorption/Regeneration in Periodontal Diseases: A Concise Review. Int J Mol Sci 2023; 24:ijms24054599. [PMID: 36902030 PMCID: PMC10003253 DOI: 10.3390/ijms24054599] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/19/2023] [Accepted: 02/06/2023] [Indexed: 03/02/2023] Open
Abstract
Periodontitis is the sixth most common chronic inflammatory disease, destroying the tissues supporting the teeth. There are three distinct stages in periodontitis: infection, inflammation, and tissue destruction, where each stage has its own characteristics and hence its line of treatment. Illuminating the underlying mechanisms of alveolar bone loss is vital in the treatment of periodontitis to allow for subsequent reconstruction of the periodontium. Bone cells, including osteoclasts, osteoblasts, and bone marrow stromal cells, classically were thought to control bone destruction in periodontitis. Lately, osteocytes were found to assist in inflammation-related bone remodeling besides being able to initiate physiological bone remodeling. Furthermore, mesenchymal stem cells (MSCs) either transplanted or homed exhibit highly immunosuppressive properties, such as preventing monocytes/hematopoietic precursor differentiation and downregulating excessive release of inflammatory cytokines. In the early stages of bone regeneration, an acute inflammatory response is critical for the recruitment of MSCs, controlling their migration, and their differentiation. Later during bone remodeling, the interaction and balance between proinflammatory and anti-inflammatory cytokines could regulate MSC properties, resulting in either bone formation or bone resorption. This narrative review elaborates on the important interactions between inflammatory stimuli during periodontal diseases, bone cells, MSCs, and subsequent bone regeneration or bone resorption. Understanding these concepts will open up new possibilities for promoting bone regeneration and hindering bone loss caused by periodontal diseases.
Collapse
|
6
|
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
|
7
|
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
|
8
|
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
|
9
|
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
|
10
|
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
|
11
|
Baumgartner D, Johannsen B, Specht M, Lüddecke J, Rombach M, Hin S, Paust N, von Stetten F, Zengerle R, Herz C, Peham JR, Paqué PN, Attin T, Jenzer JS, Körner P, Schmidlin PR, Thurnheer T, Wegehaupt FJ, Kaman WE, Stubbs A, Hays JP, Rusu V, Michie A, Binsl T, Stejskal D, Karpíšek M, Bao K, Bostanci N, Belibasakis GN, Mitsakakis K. OralDisk: A Chair-Side Compatible Molecular Platform Using Whole Saliva for Monitoring Oral Health at the Dental Practice. BIOSENSORS 2021; 11:bios11110423. [PMID: 34821641 PMCID: PMC8615610 DOI: 10.3390/bios11110423] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 05/04/2023]
Abstract
Periodontitis and dental caries are two major bacterially induced, non-communicable diseases that cause the deterioration of oral health, with implications in patients' general health. Early, precise diagnosis and personalized monitoring are essential for the efficient prevention and management of these diseases. Here, we present a disk-shaped microfluidic platform (OralDisk) compatible with chair-side use that enables analysis of non-invasively collected whole saliva samples and molecular-based detection of ten bacteria: seven periodontitis-associated (Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola) and three caries-associated (oral Lactobacilli, Streptococcus mutans, Streptococcus sobrinus). Each OralDisk test required 400 µL of homogenized whole saliva. The automated workflow included bacterial DNA extraction, purification and hydrolysis probe real-time PCR detection of the target pathogens. All reagents were pre-stored within the disk and sample-to-answer processing took < 3 h using a compact, customized processing device. A technical feasibility study (25 OralDisks) was conducted using samples from healthy, periodontitis and caries patients. The comparison of the OralDisk with a lab-based reference method revealed a ~90% agreement amongst targets detected as positive and negative. This shows the OralDisk's potential and suitability for inclusion in larger prospective implementation studies in dental care settings.
Collapse
Affiliation(s)
- Desirée Baumgartner
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Correspondence: (K.M.); (D.B.); Tel.: +49-761-203-73252 (K.M.); +49-761-203-98724 (D.B.)
| | - Benita Johannsen
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Mara Specht
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Jan Lüddecke
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Markus Rombach
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Sebastian Hin
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Nils Paust
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Felix von Stetten
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Roland Zengerle
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Christopher Herz
- AIT Austrian Institute of Technology, Molecular Diagnostics, Giefinggasse 4, 1210 Wien, Austria; (C.H.); (J.R.P.)
| | - Johannes R. Peham
- AIT Austrian Institute of Technology, Molecular Diagnostics, Giefinggasse 4, 1210 Wien, Austria; (C.H.); (J.R.P.)
| | - Pune N. Paqué
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Joël S. Jenzer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Philipp Körner
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Thomas Thurnheer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Florian J. Wegehaupt
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Wendy E. Kaman
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre Rotterdam (Erasmus MC), 3015 CN Rotterdam, The Netherlands; (W.E.K.); (J.P.H.)
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Free University of Amsterdam and University of Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Andrew Stubbs
- Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Centre Rotterdam (Erasmus MC), 3015 CN Rotterdam, The Netherlands;
| | - John P. Hays
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre Rotterdam (Erasmus MC), 3015 CN Rotterdam, The Netherlands; (W.E.K.); (J.P.H.)
| | - Viorel Rusu
- Magtivio B.V., Daelderweg 9, 6361 HK Nuth, The Netherlands;
| | - Alex Michie
- ClinicaGeno Ltd., 11 Station Approach, Coulsdon CR5 2NR, UK; (A.M.); (T.B.)
| | - Thomas Binsl
- ClinicaGeno Ltd., 11 Station Approach, Coulsdon CR5 2NR, UK; (A.M.); (T.B.)
| | - David Stejskal
- Department of Biomedical Sciences, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300 Ostrava, Czech Republic;
- Institute of Laboratory Diagnostics, University Hospital Ostrava, 17. Listopadu 1790/5, 70800 Ostrava, Czech Republic
| | - Michal Karpíšek
- BioVendor-Laboratorní Medicína a.s., Research & Diagnostic Products Division, Karasek 1767/1, Reckovice, 62100 Brno, Czech Republic;
- Faculty of Pharmacy, Masaryk University, Palackeho trida 1946/1, 61242 Brno, Czech Republic
| | - Kai Bao
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (N.B.); (G.N.B.)
| | - Nagihan Bostanci
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (N.B.); (G.N.B.)
| | - Georgios N. Belibasakis
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (N.B.); (G.N.B.)
| | - Konstantinos Mitsakakis
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Correspondence: (K.M.); (D.B.); Tel.: +49-761-203-73252 (K.M.); +49-761-203-98724 (D.B.)
| |
Collapse
|
12
|
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
|
13
|
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
|
14
|
[Periodontitis-therapy of a widespread disease]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:931-940. [PMID: 34236451 PMCID: PMC8264996 DOI: 10.1007/s00103-021-03373-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/08/2021] [Indexed: 01/19/2023]
Abstract
Parodontitis ist eine chronisch entzündliche nichtübertragbare Erkrankung, die alle Anteile des Zahnhalteapparates (Parodonts) betrifft und dort weitgehend irreversible Schäden verursacht. Schätzungen legen nahe, dass in Deutschland ca. 10 Mio. Menschen an einer schweren Parodontitis erkrankt sind. Parodontitis zeigt über viele Jahre zumeist wenige oder nur milde Symptome, die von den Patienten oft nicht wahrgenommen oder richtig eingeordnet werden. Fehlendes Bewusstsein kann dazu führen, dass zahnärztliche Behandlung erst in einem fortgeschrittenen Erkrankungsverlauf in Anspruch genommen wird, wenn umfangreiche Therapiemaßnahmen notwendig geworden sind und sich die Prognose für den Erhalt der Zähne verschlechtert hat. Der parodontale Screeningindex (PSI) ist ein einfaches und schnelles Instrument, mit dem die Notwendigkeit weiterführender diagnostischer Maßnahmen beurteilt werden kann. Der Index wird mittlerweile bei vielen Patienten durchgeführt. Trotzdem bleiben die Versorgungszahlen niedrig und hinter dem zurück, was für das Absenken der bestehenden Parodontitislast notwendig wäre. Jede Zahnarztpraxis muss in der Lage sein, Parodontitistherapie umzusetzen. Fachzahnärzte oder Spezialisten können die allgemeinzahnärztlichen Kollegen wesentlich bei der Behandlung von schweren Formen von Parodontitis unterstützen. Dazu ist eine Aufwertung des Faches in der universitären Ausbildung erforderlich, aber auch die zunehmende postgraduale Ausdifferenzierung von Spezialisten oder Fachzahnärzten für Parodontologie. Die neuen Behandlungsrichtlinien für die Parodontaltherapie (PAR-Therapie) erlauben die Versorgung der parodontal erkrankten Patienten auf Basis international anerkannter wissenschaftlicher Standards und verbessern damit die Rahmenbedingungen für die Parodontitistherapie in der zahnärztlichen Praxis.
Collapse
|
15
|
Nędzi-Góra M, Górska R, Górski B. The utility of gingival crevicular fluid matrix metalloproteinase-8 provides site-specific diagnostic value for periodontal grading. Cent Eur J Immunol 2021; 46:236-243. [PMID: 34764793 PMCID: PMC8568025 DOI: 10.5114/ceji.2021.107031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Matrix metalloproteinase-8 (MMP-8), and its active form aMMP-8, was identified as a potential biomarker of periodontal tissue destruction. It is present at different concentrations in various oral fluids. MATERIAL AND METHODS Gingival crevicular fluid (GCF) samples were collected from periodontal pockets ≥ 6 mm of 24 untreated patients using paper points and clinical parameters were recorded. 12 subjects were diagnosed with periodontitis stage III grade B, and 12 others with periodontitis stage III grade C. After thorough preparations, samples were collected following manufacturers' instructions and analyzed using a commercially available test system for aMMP-8 evaluation (aMMP-8 Test) and Periotron 8000 together with Quantikine kits for assessment of total MMP-8 concentration (controls). Microbiological evaluation of the same pockets was carried out using real-time polymerase chain reaction. RESULTS Concentrations of both total MMP-8 and aMMP-8 in GCF were higher in the case of periodontitis grade C, compared to periodontitis grade B, but reached statistical significance only in the case of total MMP-8 (77.17 ng/ml and 18.73 ng/ml respectively; p = 0.0104). Positive correlations were found between total MMP-8 and aMMP-8 levels and the prevalence of Fusobacterium nucleatum, mean probing pocket depth of all pockets, % of pockets ≥ 6 mm, as well as probing pocket depth of pocket from which GCF samples were collected. CONCLUSIONS GCF concentration levels of both total MMP-8 and aMMP-8 correlated with severity of periodontal destruction, whereas total MMP-8 appeared to be a preferable method for differentiation of periodontal grading. However, the aMMP-8 Test was easier and more convenient to handle.
Collapse
Affiliation(s)
| | - Renata Górska
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Bartłomiej Górski
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, Warsaw, Poland
- The Chair and Department of Periodontology, Medical University of Lublin, Lublin, Poland
| |
Collapse
|
16
|
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: 31] [Impact Index Per Article: 10.3] [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
|
17
|
Kim JY, Kim HN. Changes in Inflammatory Cytokines in Saliva after Non-Surgical Periodontal Therapy: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010194. [PMID: 33383828 PMCID: PMC7795738 DOI: 10.3390/ijerph18010194] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/24/2020] [Accepted: 12/25/2020] [Indexed: 12/31/2022]
Abstract
To determine the diagnostic value of inflammatory cytokines in periodontal disease, we performed a systematic review of the changes in inflammatory cytokines after non-surgical periodontal therapy and a meta-analysis of the utility of interleukin (IL)-1β and matrix metalloproteinase (MMP)-8 as salivary biomarkers. All available papers published in English until 20 August 2020, were searched in the MEDLINE and EMBASE databases. Population, intervention, comparison, and outcome data were extracted from the selected studies, and the roles of IL-1β and MMP-8 were assessed in a meta-analysis. Eleven studies, including two meta-analyses, were assessed in the systematic review. Biomarkers showing high levels in periodontal disease were salivary IL-1β, IL-4, IL-6, MMP-8, and tissue inhibitor of matrix metalloproteinases (TIMP)-2, and those in the controls were tumor necrosis factor (TNF)-α, IL-10, IL-17, and IL-32. Biomarkers that decreased after scaling and root planning (SRP) and oral hygiene instruction (OHI) in periodontitis patients were IL-1β, MMP-8, MMP-9, prostaglandin E2 (PGE2), and TIMP-2. The pooled standardized mean difference of IL-1β and MMP-8 was −1.04 and 35.90, respectively, but the differences between periodontitis patients and healthy controls were not significant. Although the changes in salivary IL-1β and MMP-8 levels after non-surgical periodontal therapy were not significant, salivary cytokines could be used to confirm the effect of periodontal therapy or diagnose periodontal disease.
Collapse
Affiliation(s)
- Ji-Youn Kim
- Department of Dental Hygiene, College of Health Science, Gachon University, Incheon 21936, Korea;
| | - Han-Na Kim
- Department of Dental Hygiene, College of Health and Medical Sciences, Cheongju University, Cheongju 28503, Korea
- Correspondence: ; Tel.: +82-43-229-8373
| |
Collapse
|
18
|
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
|
19
|
Belibasakis GN, Lund BK, Krüger Weiner C, Johannsen B, Baumgartner D, Manoil D, Hultin M, Mitsakakis K. Healthcare Challenges and Future Solutions in Dental Practice: Assessing Oral Antibiotic Resistances by Contemporary Point-Of-Care Approaches. Antibiotics (Basel) 2020; 9:E810. [PMID: 33202544 PMCID: PMC7696509 DOI: 10.3390/antibiotics9110810] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/17/2022] Open
Abstract
Antibiotic resistance poses a global threat, which is being acknowledged at several levels, including research, clinical implementation, regulation, as well as by the World Health Organization. In the field of oral health, however, the issue of antibiotic resistances, as well as of accurate diagnosis, is underrepresented. Oral diseases in general were ranked third in terms of expenditures among the EU-28 member states in 2015. Yet, the diagnosis and patient management of oral infections, in particular, still depend primarily on empiric means. On the contrary, on the global scale, the field of medical infections has more readily adopted the integration of molecular-based systems in the diagnostic, patient management, and antibiotic stewardship workflows. In this perspective review, we emphasize the clinical significance of supporting in the future antibiotic resistance screening in dental practice with novel integrated and point-of-care operating tools that can greatly support the rapid, accurate, and efficient administration of oral antibiotics.
Collapse
Affiliation(s)
- Georgios N. Belibasakis
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
| | - Bodil K. Lund
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
- Department of Clinical Dentistry, University of Bergen, 5009 Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, 5021 Bergen, Norway
| | - Carina Krüger Weiner
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
- Department of Oral and Maxillofacial Surgery, Folktandvården Stockholm, Eastman Institutet, 11324 Stockholm, Sweden
| | - Benita Johannsen
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
| | - Desirée Baumgartner
- Laboratory for MEMS Applications, IMTEK—Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
| | - Daniel Manoil
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
| | - Margareta Hultin
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
| | - Konstantinos Mitsakakis
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
- Laboratory for MEMS Applications, IMTEK—Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
| |
Collapse
|
20
|
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
|
21
|
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
|
22
|
Keles Yucel ZP, Afacan B, Emingil G, Tervahartiala T, Kose T, Sorsa T. Local and systemic levels of aMMP‐8 in gingivitis and stage 3 grade C periodontitis. J Periodontal Res 2020; 55:887-894. [DOI: 10.1111/jre.12781] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/21/2020] [Accepted: 05/30/2020] [Indexed: 12/19/2022]
Affiliation(s)
| | - Beral Afacan
- Department of Periodontology School of Dentistry Aydın Adnan Menderes University Aydin Turkey
| | - Gulnur Emingil
- Department of Periodontology School of Dentistry Ege University Izmir Turkey
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases Helsinki University Hospital University of Helsinki Helsinki Finland
| | - Timur Kose
- Department of Biostatistics and Medical Informatics School of Medicine Ege University Izmir Turkey
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases Helsinki University Hospital University of Helsinki Helsinki Finland
- Department of Oral Diseases Karolinska Institute Huddinge Sweden
| |
Collapse
|
23
|
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
|
24
|
Sopi M, Koçani F, Bardhoshi M, Meqa K. Clinical and Biochemical Evaluation of the Effect of Diode Laser Treatment Compared to the Non-surgical and Surgical Treatment of Periodontal Diseases. Open Dent J 2020. [DOI: 10.2174/1874210602014010281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Periodontal therapy consists of eliminating the inflammation, treating periodontal pockets, motivating the patient for oral hygiene, and, if necessary, for surgical treatment. Recently, the application of a diode laser is widely being investigated for periodontal disease treatment.
Objective:
The analysis and evaluation of the clinical and biochemical impact of diode laser periodontal treatment, compared to either surgical or non-surgical, therapy, was the aim of this study.
Methods:
The study involved 80 patients older than 18 with at least 20 teeth. Evaluation of periodontal parameters was done conveniently on a single-rooted tooth (incisive, canine, premolar) on six surfaces, before the start of periodontal therapy, and after three, and six months. The laser used in the study was a diode laser with a wavelength of 980 nm. Digital X-rays were taken for bone level evaluation before and after the treatment. The presence of a bone destruction mediator (Matrix metalloproteinase-8 - MMP-8) was evaluated by the dipstick immunoassay test. Biochemical analysis and radiographic measurements were evaluated at the baseline and six months after the treatment. The statistical analysis included χ2-test and one-way ANOVA.
Results:
The results of this study showed that diode laser treatment was more effective in reducing periodontal clinical parameters, lowering MMP-8 levels and reducing the bone loss, compared to the group treated with scaling and root planning, or with a surgical approach.
Conclusion:
Diode laser may be considered as an effective alternative for periodontal treatment, with benefits in clinical and biochemical parameters.
Collapse
|
25
|
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
|
26
|
Kc S, Wang XZ, Gallagher JE. Diagnostic sensitivity and specificity of host-derived salivary biomarkers in periodontal disease amongst adults: Systematic review. J Clin Periodontol 2019; 47:289-308. [PMID: 31701554 DOI: 10.1111/jcpe.13218] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/03/2019] [Accepted: 10/30/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To systematically assess the diagnostic value of host-derived salivary biomarkers based on their reported sensitivity and specificity in relation to clinical parameters of periodontal disease diagnosis in adults. MATERIALS AND METHODS Comprehensive search of PubMed, Nature, Cochrane and OVID (Embase, MEDLINE [R] and PsycINFO) was conducted up to 1 August 2018, using key terms relevant to the research questions and Cochrane methodology, supplemented by a grey literature search. The revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS- 2) tool was used to assess the methodological quality of all included studies. RESULTS Seven studies were included in the review. Macrophage inflammatory protein-1αlpha (MIP-1α), interleukin-1beta (IL-1β), interleukin-6 (IL-6) and matrix metalloproteinase-8 (MMP-8) were identified as diagnostically acceptable biomarkers for periodontal disease. Overall, the combination of IL-6 and MMP-8 showed best diagnostic performance. Also, a combination of the four key biomarkers (IL-1β, IL-6, MMP-8 and MIP-1α) showed promising results for distinction between gingivitis and periodontitis, as well as for periodontitis compared with gingival health. Results are interpreted with caution due to limitations in the number of studies included and their quality. CONCLUSION Certain salivary biomarkers can potentially be useful in combination and singularly for the diagnosis of periodontal disease. However, further methodically robust research is required to validate these biomarkers.
Collapse
Affiliation(s)
- Sukriti Kc
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Xiaozhe Z Wang
- Kings College London Dental Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Jennifer E Gallagher
- Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, London, UK
| |
Collapse
|
27
|
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]
|
28
|
Arias-Bujanda N, Regueira-Iglesias A, Balsa-Castro C, Nibali L, Donos N, Tomás I. Accuracy of single molecular biomarkers in saliva for the diagnosis of periodontitis: A systematic review and meta-analysis. J Clin Periodontol 2019; 47:2-18. [PMID: 31560804 DOI: 10.1111/jcpe.13202] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/25/2019] [Accepted: 09/13/2019] [Indexed: 12/20/2022]
Abstract
AIM To analyse, using a meta-analytical approach, the diagnostic accuracy of single molecular biomarkers in saliva for the detection of periodontitis in systemically healthy subjects. MATERIALS AND METHODS Articles on molecular biomarkers in saliva providing a binary contingency table (or sensitivity and specificity values and group sample sizes) in individuals with clinically diagnosed periodontitis were considered eligible. Searches for candidate articles were conducted in six electronic databases. The methodological quality was assessed through the tool Quality Assessment of Diagnostic Studies. Meta-analyses were performed using the Hierarchical Summary Receiver Operating Characteristic model. RESULTS Meta-analysis was possible for 5 of the 32 biomarkers studied. The highest values of sensitivity for the diagnosis of periodontitis were obtained for IL1beta (78.7%), followed by MMP8 (72.5%), IL6 and haemoglobin (72.0% for both molecules); the lowest sensitivity value was for MMP9 (70.3%). In terms of specificity estimates, MMP9 had the best result (81.5%), followed by IL1beta (78.0%) and haemoglobin (75.2%); MMP8 had the lowest specificity (70.5%). CONCLUSIONS MMP8, MMP9, IL1beta, IL6 and Hb were salivary biomarkers with good capability to detect periodontitis in systemically healthy subjects. MMP8 and IL1beta are the most researched biomarkers in the field, both showing clinically fair effectiveness for the diagnosis of periodontitis.
Collapse
Affiliation(s)
- Nora Arias-Bujanda
- Oral Sciences Research Group, Department of Surgery and Medical-Surgical Specialties, School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Alba Regueira-Iglesias
- Oral Sciences Research Group, Department of Surgery and Medical-Surgical Specialties, School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Balsa-Castro
- Oral Sciences Research Group, Department of Surgery and Medical-Surgical Specialties, School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Luigi Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Nikos Donos
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Queen Mary University of London, London, UK
| | - Inmaculada Tomás
- Oral Sciences Research Group, Department of Surgery and Medical-Surgical Specialties, School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| |
Collapse
|
29
|
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
|
30
|
Taylor JJ, Jaedicke KM, van de Merwe RC, Bissett SM, Landsdowne N, Whall KM, Pickering K, Thornton V, Lawson V, Yatsuda H, Kogai T, Shah D, Athey D, Preshaw PM. A Prototype Antibody-based Biosensor for Measurement of Salivary MMP-8 in Periodontitis using Surface Acoustic Wave Technology. Sci Rep 2019; 9:11034. [PMID: 31363141 PMCID: PMC6667706 DOI: 10.1038/s41598-019-47513-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/18/2019] [Indexed: 12/16/2022] Open
Abstract
Periodontitis is an economically important disease which is highly prevalent worldwide. Current diagnostic approaches are time-consuming and require interpretation of multiple aspects of clinical and radiographic assessment. Chair-side monitoring of inflammatory mediators of periodontitis could provide immediate information about disease activity, which can inform patient management. We aimed to develop a novel prototype biosensor to measure salivary matrix metalloproteinase-8 (MMP-8) using specific antibodies and surface acoustic wave (SAW) technology. The analytical performance of the prototype biosensor was compared to standard enzyme-linked immunosorbent assay (ELISA) using unstimulated saliva samples obtained from patients with periodontitis before and after non-surgical treatment (N = 58), patients with gingivitis (N = 54) and periodontally healthy volunteers (N = 65). Receiver operator characteristic (ROC) analysis for distinguishing periodontitis from health revealed an almost identical performance between the sensor and ELISA assays (area under curve values (AUC): ELISA 0.93; SAW 0.89). Furthermore, both analytical approaches yielded readouts which distinguished between heath, gingivitis and periodontitis, correlated identically with clinical measures of periodontal disease and recorded similar post-treatment decreases in salivary MMP-8 in periodontitis. The assay time for our prototype device is 20 minutes. The prototype SAW biosensor is a novel and rapid method of monitoring periodontitis which delivers similar analytical performance to conventional laboratory assays.
Collapse
Affiliation(s)
- John J Taylor
- Centre for Oral Health Research & Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
| | - Katrin M Jaedicke
- Centre for Oral Health Research & Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Rachel C van de Merwe
- Centre for Oral Health Research & Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Susan M Bissett
- Centre for Oral Health Research & Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Nichola Landsdowne
- Centre for Oral Health Research & Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Kerry M Whall
- Centre for Oral Health Research & Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Kimberley Pickering
- Centre for Oral Health Research & Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Vivienne Thornton
- OJ-Bio, International Centre for Life, Times Square, Newcastle upon Tyne, UK
| | - Victoria Lawson
- OJ-Bio, International Centre for Life, Times Square, Newcastle upon Tyne, UK
| | - Hiromi Yatsuda
- OJ-Bio, International Centre for Life, Times Square, Newcastle upon Tyne, UK
| | - Takashi Kogai
- OJ-Bio, International Centre for Life, Times Square, Newcastle upon Tyne, UK
| | - Deepan Shah
- Orla Protein Technologies, International Centre for Life, Times Square, Newcastle upon Tyne, UK
| | - Dale Athey
- OJ-Bio, International Centre for Life, Times Square, Newcastle upon Tyne, UK.,Orla Protein Technologies, International Centre for Life, Times Square, Newcastle upon Tyne, UK
| | - Philip M Preshaw
- Centre for Oral Health Research & Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,National University Centre for Oral Health, National University of Singapore, Singapore, Singapore
| |
Collapse
|
31
|
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
|
32
|
Abdul Rahman N, Nickles K, Gallenbach K, Dannewitz B, Ramich T, Scharf S, Röllke L, Schacher B, Eickholz P. Five-year stability of clinical attachment after regenerative treatment of infrabony defects compared to controls. J Clin Periodontol 2019; 46:650-658. [PMID: 30972774 DOI: 10.1111/jcpe.13105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 02/12/2019] [Accepted: 03/31/2019] [Indexed: 12/01/2022]
Abstract
AIM To evaluate the stability of attachment achieved in infrabony defects by regenerative treatment over 60 ± 12 months compared to control teeth. METHODS Patients treated regeneratively in at least one infrabony defect between 2004 and 2010 were screened for this retrospective cohort study. Complete examinations available for baseline, 12 and 60 ± 12 months after surgery, and a respective control tooth without treatment, provided eligibility for analysis. RESULTS Twenty-seven patients (age 58 ± 11.7 years; 12 females, five smokers) were included, each contributing one infrabony defect and one control tooth. Regenerative therapy resulted in significant attachment gain (2.7 ± 1.6 mm; p < 0.001) after 1 and (3.0 ± 2.2 mm; p < 0.001) 5 years. Control teeth were stable (vertical probing attachment level [PAL-V] change: 1 year: 0 ± 0.8 mm; 5 years: -0.2 ± 1.2 mm). The study did not detect any significant change of PAL-V from 1 to 5 years after surgery for regenerative (-0.3 ± 2.4 mm) and control teeth (-0.2 ± 1.4 mm). Multivariate analysis associated smoking and generalized recurrence of periodontitis (amount of sites with PPD > 5 mm) with attachment loss. CONCLUSIONS PAL-V achieved by regenerative therapy in infrabony defects is as stable over 5 years as periodontally reduced but gingivally healthy or gingivitis sites. Smoking and periodontitis recurrence are associated with attachment loss.
Collapse
Affiliation(s)
- Natalie Abdul Rahman
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt, Frankfurt am Main, Germany
| | - Katrin Nickles
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt, Frankfurt am Main, Germany
| | - Kerstin Gallenbach
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt, Frankfurt am Main, Germany
| | - Bettina Dannewitz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt, Frankfurt am Main, Germany
| | - Tatjana Ramich
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt, Frankfurt am Main, Germany
| | - Susanne Scharf
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt, Frankfurt am Main, Germany
| | - Lasse Röllke
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt, Frankfurt am Main, Germany
| | - Beate Schacher
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt, Frankfurt am Main, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt, Frankfurt am Main, Germany
| |
Collapse
|
33
|
Deumer J, Frentzen M, Meinke M. Investigation of active matrix- metaloproteinase-8 (aMMP-8) as a reference parameter for path control in antimicrobial photothermal therapy (aPTT) using a split-mouth design. Heliyon 2019; 5:e01661. [PMID: 31193352 PMCID: PMC6526226 DOI: 10.1016/j.heliyon.2019.e01661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 01/25/2019] [Accepted: 05/01/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES This retrospective data-collection study aims to explain how the active matrix-metalloproteinase-8-titer (aMMP-titer) influences the immune response of the subject. This is done through monotherapy scaling and root planing (SRP) which is then compared to SRP combined with antimicrobial photothermal therapy (aPTT, Emundo®). METHODS Data collection was monocentric, randomized and split-mouth based. A study group of twenty patients with chronic periodontal disease with a periodontal pocket depth (PPD) 4 mm ≤ PPD ≤8 mm, a periodontal screening index (PSI: > 3), and a gingival recession ≤2 mm were selected.A diode laser, manufactured by A.R.C. Laser GmbH, with 810 nm wavelength was used. This device implemented three different light transmission systems for transgingival and intra-gingival irradiation. Power settings between 200 and 300 mW were deployed for 10 s during all treatment steps. The photothermic dye of EmunDo® system (A.R.C. Laser GmbH) was infracyaningreen.The adjuvant effect of the antimicrobial photothermal therapy (aPTT) with EmunDo® in combination with conventional SRP on the teeth 15 and 35 was compared with the results of monotherapy SRP on teeth 25 and 45. RESULTS A reduction of the aMMP-8-titer in gingival crevicular fluid (GCF) was observed in both groups (follow up group and control group) after one month. However; the decrease in the follow up group under SRP in combination with aPTT was significantly more pronounced. The periodontal pocket depths was reduced in both treatment groups. The periodontal probing depth (in mm) shows a larger decrease of the periodontal pocket depth within the follow up group (SPR with aPTT) compared with the control group (SRP). CONCLUSION The aMMP-8-titer showed differences in both groups prior to and after treatment. Active matrix-metalloproteinase-8 (aMMP-8) as a reference parameter for path control in antimicrobial photothermal therapy (aPTT) seems acceptable.
Collapse
Affiliation(s)
- J. Deumer
- MVZ Erstes Zahnärztliches Lasercentrum Berlin, Gatower Straße 296, 14089 Berlin, Germany
| | - M. Frentzen
- Department of Operative and Preventive Dentistry, Bonn University, Dental Faculty, Germany
| | - M.C. Meinke
- Department of Dermatology, Venereology and Allergology, Charité University Medicine Berlin Campus Charité Mitte, Germany
| |
Collapse
|
34
|
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
|
35
|
Nascimento GG, Baelum V, Sorsa T, Tervahartiala T, Skottrup PD, López R. Salivary levels of MPO, MMP-8 and TIMP-1 are associated with gingival inflammation response patterns during experimental gingivitis. Cytokine 2019; 115:135-141. [PMID: 30626536 DOI: 10.1016/j.cyto.2018.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/10/2018] [Indexed: 01/15/2023]
Abstract
AIM This study aimed to investigate the association between salivary levels of myeloperoxidase (MPO), neutrophil elastase (NE), soluble urokinase-type plasminogen activator receptor (suPAR), matrix metalloproteinase (MMP)-8 and tissue inhibitor of matrix metalloproteinases (TIMP)-1 and gingival inflammation development during an experimental gingivitis study. METHODS A three-week experimental gingivitis study was conducted. Clinical recordings of dental plaque biofilm (Modified Quigley Hein Plaque Index, TQHPI) and gingival inflammation (Modified Gingival Index, MGI) were made at specific time points for each of the 42 participants. Salivary levels of MPO, NE, suPAR, MMP-8 and TIMP-1 at the same time points were measured using distinct immunoassays. For data analysis growth curve modelling was employed to account for the time-varying outcome (MGI score) and the time-varying covariates (salivary marker levels, and TQHPI score). Analyses were stratified according to the MGI-score trajectory groups previously identified as 'fast', respectively 'slow' responders. RESULTS Overall, higher MGI scores were statistically significantly positively associated with higher levels of MPO, MMP-8 and TIMP-1. Stratified analysis according to inflammation development trajectory group revealed higher levels of salivary MPO, MMP-8 and MMP-8/TIMP-1 ratio among the 'fast' responders than among 'slow' responders. None of the investigated salivary protein markers was associated with a 'slow' inflammation development response. CONCLUSIONS Salivary levels of MPO, MMP-8 and TIMP-1 were associated with the extent and severity of gingival inflammation. While the 'fast' gingival inflammation response was associated with increased levels of MPO, MMP-8 and MMP-8/TIMP-1 ratio, the 'slow' response was not associated with any of the salivary protein markers investigated in this study. Neutrophil activity seems to orchestrate a 'fast' gingival inflammatory response among participants previously primed to gingival inflammation.
Collapse
Affiliation(s)
- Gustavo G Nascimento
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
| | - Vibeke Baelum
- Section of Oral Epidemiology and Public Health, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Peter D Skottrup
- Department of Clinical Biochemistry, Copenhagen University Hospital, Hvidovre DK-2650, Hvidovre, Denmark; Novo Nordisk A/S, Research Bioanalysis, Global Research Technologies, DK-2760 Måløv, Denmark
| | - Rodrigo López
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
36
|
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
|
37
|
Al-Majid A, Alassiri S, Rathnayake N, Tervahartiala T, Gieselmann DR, Sorsa T. Matrix Metalloproteinase-8 as an Inflammatory and Prevention Biomarker in Periodontal and Peri-Implant Diseases. Int J Dent 2018; 2018:7891323. [PMID: 30305812 PMCID: PMC6165625 DOI: 10.1155/2018/7891323] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 08/08/2018] [Indexed: 12/11/2022] Open
Abstract
Levels of and especially the degree of activation of matrix metalloproteinase (MMP-8) in oral fluids (i.e., saliva, mouth rinse, gingival crevicular fluid (GCF) and peri-implantitis sulcular fluid (PISF)) increase to pathologically elevated levels in the periodontal and peri-implant diseases. This study aimed at collecting and collating data from previously published studies and determining whether active MMP-8 (aMMP-8) could serve as a biomarker for the diagnosis and prevention of periodontal and peri-implant diseases. The literature search identified a total of 284 articles. Out of 284 articles, 61 articles were found to be relevant. Data obtained from the selected studies were combined, and it indicated that aMMP-8 in oral fluids exerts the strong potential to serve as a useful adjunctive diagnostic and preventive biotechnological tool in periodontal and peri-implant diseases. aMMP-8 can be used alone or in combination with other proinflammatory and/or microbiological biomarkers.
Collapse
Affiliation(s)
- Ahmed Al-Majid
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Saeed Alassiri
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nilminie Rathnayake
- Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Dirk-Rolf Gieselmann
- Institute of Molecular Diagnostics, Dentognostics GmbH, Solingen and Jena, Germany
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden
| |
Collapse
|
38
|
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
|
39
|
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
|
40
|
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
|
41
|
Epping L, Miesbach W, Nickles K, Eickholz P. Is gingival bleeding a symptom of type 2 and 3 von Willebrand disease? PLoS One 2018; 13:e0191291. [PMID: 29370241 PMCID: PMC5784962 DOI: 10.1371/journal.pone.0191291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 01/01/2018] [Indexed: 11/18/2022] Open
Abstract
Background Von Willebrand disease (VWD) is the most common inherent bleeding disorder. Gingival bleeding is a frequently reported symptom of VWD. However, gingival bleeding is also a leading symptom of plaque-induced gingivitis and untreated periodontal disease. In type 1 VWD gingival bleeding was not increased compared to controls. Thus, this study evaluated whether type 2 and 3 VWD determines an increased susceptibility to gingival bleeding in response to the oral biofilm. Methods Twenty-four cases and 24 controls matched for age, sex, periodontal diagnosis, number of teeth and smoking were examined hematologically (VWF antigen, VWF activity, factor VIII activity) and periodontally (Gingival Bleeding Index [GBI]), bleeding on probing [BOP], Plaque Control Record [PCR], periodontal inflamed surface area [PISA], vertical probing attachment level). Results BOP (VWD: 14.5±10.1%; controls: 12.3±5.3%; p = 0.542) and GBI (VWD: 10.5±9.9%; controls: 8.8±4.8%; p = 0.852) were similar for VWD and controls. Multiple regressions identified female sex, HbA1c, PCR and PISA to be associated with BOP. HbA1c and PCR were associated with GBI. Number of remaining teeth was negatively correlated with BOP and GBI. Conclusion Type 2 and 3 VWD are not associated with a more pronounced inflammatory response to the oral biofilm in terms of BOP and GBI.
Collapse
Affiliation(s)
- Lisa Epping
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany
| | - Wolfgang Miesbach
- Department of Haemostaseology/Haemophilia Centre, Medical Clinic II/Institute for Transfusion Medicine, University Hospital Frankfurt, Frankfurt/Main, Germany
| | - Katrin Nickles
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany
- * E-mail:
| |
Collapse
|
42
|
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
|
43
|
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
|
44
|
de Morais EF, Pinheiro JC, Leite RB, Santos PPA, Barboza CAG, Freitas RA. Matrix metalloproteinase-8 levels in periodontal disease patients: A systematic review. J Periodontal Res 2017; 53:156-163. [PMID: 28898418 DOI: 10.1111/jre.12495] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2017] [Indexed: 12/20/2022]
Abstract
Periodontal disease is characterized as a disorder of the oral microbiota resulting in an immune response which, in turn, leads to the destruction of periodontal tissue. Matrix metalloproteinase-8 (MMP-8) has been reported as the major metalloproteinase involved in periodontal disease, being present at high levels in gingival crevicular fluid and salivary fluid (SF). The aim of this systematic review was to evaluate the scientific literature regarding the expression of MMP-8 in gingival crevicular fluid and SF in patients with periodontal disease, analyzing its validity as a possible biomarker in the diagnosis of periodontal disease. A systematic review of the literature was performed using the PubMed/Medline, CENTRAL and Science Direct databases. Studies concerning the use of MMP-8 in the diagnosis of periodontal disease that evaluated its effectiveness as a biomarker for periodontal disease were selected. The search strategy provided a total of 6483 studies. After selection, six articles met all the inclusion criteria and were included in the present systematic review. The studies demonstrated significantly higher concentrations of MMP-8 in patients with periodontal disease compared with controls, as well as in patients presenting more advanced stages of periodontal disease. The findings on higher MMP-8 concentrations in patients with periodontal disease compared with controls imply the potential adjunctive use of MMP-8 in the diagnosis of periodontal disease.
Collapse
Affiliation(s)
- E F de Morais
- Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - J C Pinheiro
- Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - R B Leite
- Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - P P A Santos
- Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - C A G Barboza
- Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - R A Freitas
- Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| |
Collapse
|
45
|
Schmidt J, Guder U, Kreuz M, Löffler M, Kiess W, Hirsch C, Ziebolz D, Haak R. aMMP-8 in correlation to caries and periodontal condition in adolescents-results of the epidemiologic LIFE child study. Clin Oral Investig 2017; 22:449-460. [PMID: 28578462 DOI: 10.1007/s00784-017-2132-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 05/15/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The suitability of a chairside aMMP-8 test in determination of periodontal inflammation and caries in adolescents was assessed. Secondly, the influence of orthodontic treatment on aMMP-8 test result was analyzed. MATERIALS AND METHODS Within the LIFE Child study, 434 adolescents (10 to 18 years) were included. Clinical dental examinations comprised caries experience (DMF/T-Index), signs of periodontal inflammation (probing pocket depth, PPD; community periodontal index of treatment needs; CPITN) at six index teeth and oral hygiene (OH). Information about orthodontic appliances (OA) and socioeconomic status (SES) were obtained by validated questionnaires. Test's sensitivity and specificity to detect periodontal inflammation and carious lesions were evaluated. The influence of OA on the test result was analyzed (multivariate model). RESULTS No associations between age, gender, SES or OH, and test outcome were found (p > 0.05). Positive test results correlated to periodontal findings (CPITN, mean PPD; p < 0.001). However, for the detection of ≥ 1 site(s) with PPD ≥ 4 mm, the test's sensitivity and specificity were found to be 61 and 69%, respectively. Multivariate analysis revealed a higher probability for a positive test result in cases of fixed OA (odds ratio 5.02, 95% confidence interval 1.90-13.19). The test had no diagnostic value considering carious lesions. CONCLUSIONS The chairside aMMP-8 test does not reliably identify adolescents with periodontal inflammation. Positive test results were more frequent in case of OA. CLINICAL RELEVANCE The chairside aMMP-8 test is no appropriate tool to screen children and adolescents neither for periodontal inflammation nor for carious lesions.
Collapse
Affiliation(s)
- Jana Schmidt
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany.
| | - Ulrike Guder
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany
| | - Markus Kreuz
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Härtelstrasse 16-18, 04107, Leipzig, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Härtelstrasse 16-18, 04107, Leipzig, Germany.,LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany.,Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103, Leipzig, Germany
| | - Christian Hirsch
- Department of Pediatric and Preventive Dentistry, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany
| |
Collapse
|
46
|
Nickles K, Dannewitz B, Gallenbach K, Ramich T, Scharf S, Röllke L, Schacher B, Eickholz P. Long-Term Stability After Regenerative Treatment of Infrabony Defects: A Retrospective Case Series. J Periodontol 2017; 88:536-542. [DOI: 10.1902/jop.2017.160704] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Katrin Nickles
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
| | - Bettina Dannewitz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
| | - Kerstin Gallenbach
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
| | - Tatjana Ramich
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
| | - Susanne Scharf
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
| | - Lasse Röllke
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
| | - Beate Schacher
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
| | - Peter Eickholz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
| |
Collapse
|
47
|
O'Brien-Simpson NM, Burgess K, Lenzo JC, Brammar GC, Darby IB, Reynolds EC. Rapid Chair-Side Test for Detection of Porphyromonas gingivalis. J Dent Res 2017; 96:618-625. [PMID: 28182517 DOI: 10.1177/0022034517691720] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Porphyromonas gingivalis is a keystone pathogen of chronic periodontitis, and its intraoral levels have been shown to predict disease progression (activity). An accurate and sensitive chair-side (point of care) test to determine disease activity is critical for early intervention and clinical management of disease. This study aimed to develop a rapid, chair-side, saliva-based detection of P. gingivalis. Monoclonal antibodies (mAbs) to the A1-adhesin domain of the P. gingivalis RgpA-Kgp proteinase-adhesin complex were screened by enzyme-linked immunosorbent assay and microbial flow cytometry, with 2 mAbs shown to recognize all laboratory and clinical strains tested, without significantly cross-reacting with other oral bacteria tested. With these mAbs, an immunochromatographic device was produced and shown in preclinical studies to detect, in inoculated saliva, all P. gingivalis laboratory strains and clinical isolates tested. The device was able to detect ≥1 × 105 P. gingivalis cells/mL. In a patient age- and sex-matched control clinical cohort, P. gingivalis levels in saliva-as measured by real-time polymerase chain reaction-positively correlated with P. gingivalis levels in subgingival plaque ( r = 0.819, P < 0.01) and clinical parameters of disease ( r = 0.633, P < 0.01). A positive device result strongly correlated with P. gingivalis levels >1 × 105 cells/mL in saliva ( r = 0.778, P < 0.001) and subgingival plaque ( r = 0.715, P < 0.001) with sensitivity, specificity, positive/negative predictive values, and accuracy levels of 95.0%, 93.3%, 90.5%, 96.6%, and 94.0%, respectively. The device result also positively correlated ( r = 0.695, P < 0.01) with disease severity as measured by probing depth. Detection of P. gingivalis in saliva was found to be rapid, taking 3 min from sample collection.
Collapse
Affiliation(s)
- N M O'Brien-Simpson
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Victoria, Australia
| | - K Burgess
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Victoria, Australia
| | - J C Lenzo
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Victoria, Australia
| | - G C Brammar
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Victoria, Australia
| | - I B Darby
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Victoria, Australia
| | - E C Reynolds
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Victoria, Australia
| |
Collapse
|
48
|
Salivary Diagnostics-Point-of-Care diagnostics of MMP-8 in dentistry and medicine. Diagnostics (Basel) 2017; 7:diagnostics7010007. [PMID: 28117682 PMCID: PMC5373016 DOI: 10.3390/diagnostics7010007] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/06/2017] [Accepted: 01/12/2017] [Indexed: 12/12/2022] Open
Abstract
Human saliva is an easily accessible biological fluid and contains a variety of disease-related biomarkers, which makes it a potential diagnostic medium. The clinical use of salivary/oral fluid biomarkers to identify oral and systemic conditions requires the development of non-invasive screening and diagnostic technologies, and is among the main goals of oral fluid researchers. 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 sulcular fluid (PISF)) is demanding. Several factors influence their expression and release; these factors include the intracellular location, the molecular size and the flow characteristics of the biological fluid. The type of saliva/oral fluid utilized for the diagnostics affects the analysis. High sensitivity together with sophisticated methods and techniques are essential to get a useful outcome. We describe here a recently developed mouth-rinse that is practical, convenient and inexpensive, as well as PISF chair-side/point of care (PoC) lateral-flow active matrix metalloproteinase (aMMP-8) immunoassays to detect, predict and monitor the course and treatment of periodontitis and peri-implantitis.
Collapse
|
49
|
Heikkinen AM, Raivisto T, Kettunen K, Kovanen L, Haukka J, Pakbaznejad Esmaeili E, Elg J, Gieselmann DR, Rathnayake N, Ruokonen H, Tervahartiala T, Sorsa T. Pilot Study on the Genetic Background of an Active Matrix Metalloproteinase-8 Test in Finnish Adolescents. J Periodontol 2016; 88:464-472. [PMID: 27989222 DOI: 10.1902/jop.2016.160441] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND In periodontitis, genetics and smoking play important roles in host immune system response. The aim of this study is to determine whether the genetic background of initial periodontitis and caries could be detected using an active matrix metalloproteinase (aMMP)-8 chairside test in Finnish adolescents. METHODS Forty-seven participants gave approval for analysis of both oral fluid collection and DNA. An aMMP-8 chairside test was performed on participants (adolescents aged 15 to 17 years), and full-mouth clinical parameters of oral health were assessed including periodontal, oral mucosal, and caries status in Eastern Finland from 2014 to 2015. DNA was extracted from oral fluid samples and genotyped for 71 polymorphisms in 29 candidate genes for periodontitis. Results were analyzed using a logistic regression model. P values were corrected for multiple testing using false discovery rate (<0.05). RESULTS aMMP-8 chairside test positivity and three or more ≥4 mm pockets were associated with vitamin D receptor (VDR) (rs2228570, P = 0.002, q = 0.04) and MMP3 (rs520540, rs639752, rs679620, P = 0.0009, 0.003, 0.003, q = 0.04, respectively). None of the other single-nucleotide polymorphisms studied showed a significant association with the aMMP-8 chairside test and at least one caries lesion positivity. CONCLUSION Genetic polymorphisms of MMP3 and VDR are linked to initial periodontitis in Finnish adolescents, and the aMMP-8 chairside test can eventually detect initial periodontitis in young patients with predisposing genetic background.
Collapse
Affiliation(s)
- Anna Maria Heikkinen
- 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
| | - Kaisa Kettunen
- Institute for Molecular Medicine (FIMM), Helsinki, Finland
| | - Leena Kovanen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Jari Haukka
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland.,Department of Public Health, Clinicum, University of Helsinki
| | - Elmira Pakbaznejad Esmaeili
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jessica Elg
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | | | - Hellevi Ruokonen
- 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.,Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| |
Collapse
|
50
|
Johnson N, Ebersole JL, Kryscio RJ, Danaher RJ, Dawson D, Al-Sabbagh M, Miller CS. Rapid assessment of salivary MMP-8 and periodontal disease using lateral flow immunoassay. Oral Dis 2016; 22:681-7. [PMID: 27273425 DOI: 10.1111/odi.12521] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/04/2016] [Accepted: 06/03/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The objective of this study was to determine the efficacy of a novel point-of-care immunoflow device (POCID) for detecting matrix metalloproteinase (MMP)-8 concentrations in oral fluids in comparison with a gold standard laboratory-based immunoassay. METHODS Oral rinse fluid and whole expectorated saliva samples were collected from 41 participants clinically classified as periodontally healthy or diseased. Samples were analyzed for MMP-8 by Luminex immunoassay and POCID. Photographed POCID results were assessed by optical scan and visually by two examiners. Data were analyzed by Pearson's correlation and receiver-operating characteristics. RESULTS MMP-8 was readily detected by the POCID, and concentrations correlated well with Luminex for both saliva and rinse fluids (r = 0.57-0.93). Thresholds that distinguished periodontitis from health were delineated from both the optical scans and visual reads of the POCID (sensitivity: 0.7-0.9, specificity: 0.5-0.7; P < 0.05). CONCLUSIONS Performance of this POCID for detecting MMP-8 in oral rinse fluid or saliva was excellent. These findings help demonstrate the utility of salivary biomarkers for distinguishing periodontal disease from health using a rapid point-of-care approach.
Collapse
Affiliation(s)
- N Johnson
- Department of Oral Health Practice, University of Kentucky, Lexington, KY, USA
| | - J L Ebersole
- Department of Oral Health Practice, University of Kentucky, Lexington, KY, USA.,Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - R J Kryscio
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - R J Danaher
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - D Dawson
- Department of Oral Health Practice, University of Kentucky, Lexington, KY, USA.,Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - M Al-Sabbagh
- Department of Oral Health Practice, University of Kentucky, Lexington, KY, USA
| | - C S Miller
- Department of Oral Health Practice, University of Kentucky, Lexington, KY, USA. .,Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA.
| |
Collapse
|