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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.
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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.
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Yilmaz M, Sorsa T, Demir E, Gürsoy M, Suominen A, Tervahartiala T, Räisänen IT, Gürsoy UK. Accuracy of aMMP-8 point-of-care test in indicating periodontal treatment outcomes in stage III/IV periodontitis: A 24-week follow-up study. J Periodontal Res 2023; 58:325-335. [PMID: 36618000 DOI: 10.1111/jre.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To analyse the correspondence between aMMP-8 PoC test results and the clinical endpoints of non-surgical periodontal treatment in stage III/IV periodontitis. BACKGROUND The diagnostic success of the active-matrix metalloproteinase-8 (aMMP-8) point-of-care (PoC) test has been demonstrated in various studies, but the evidence of its accuracy following periodontal treatment is limited. MATERIALS AND METHODS Altogether 42 stage III/IV grade C periodontitis patients were included in this prospective diagnostic study. Clinical periodontal indices were recorded, aMMP-8 PoC test was applied and mouthrinse was collected before and at 6, 12 and 24 weeks after non-surgical periodontal treatment. Quantitative aMMP-8 levels were determined with immunofluorometric assay (IFMA) for the verification of the PoC test results. The accuracy of the aMMP-8 PoC test was assessed using previously established clinical endpoints as references. RESULTS Sensitivity and specificity of aMMP-8 PoC test to indicate clinical endpoints were ranged as follows: Sensitivity 71.4% at baseline, 39.3%-42.4% at week 6, 28.6%-32.4% at week 12 and 35.3%-42.9% at week 24; specificity 64.3%-80% at week 6, 40%-57.1% at week 12 and 56%-64.3% at week 24. CONCLUSIONS The accuracy of aMMP-8 PoC test in identifying clinical endpoints after non-surgical periodontal treatment is reduced in relation to baseline. Individual healing patterns of each diseased pocket eventually limit the accuracy of the dichotomous aMMP-8 oral rinse test during the post-treatment period.
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Affiliation(s)
- Mustafa Yilmaz
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland.,Department of Periodontology, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Esra Demir
- Department of Periodontology, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Mervi Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ulvi K Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
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Neopterin Levels in Periodontitis and after Nonsurgical Periodontal Therapy: Evaluation of Gingival Crevicular Fluid, Oral Fluid, Serum and Urinary Samples-A Case-Control Study. Biomedicines 2022; 10:biomedicines10123200. [PMID: 36551955 PMCID: PMC9776342 DOI: 10.3390/biomedicines10123200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Periodontitis is a chronic inflammatory disease that leads to the destruction of the tooth-supporting tissues with complex immune response. Neopterin (Np), secreted via activated macrophages, is considered a biomarker of cellular immunity. The aim of this study was to evaluate the impact of periodontitis and nonsurgical periodontal therapy. Np gingival crevicular fluid (GCF), oral fluid, serum and urine levels were compared in subjects with periodontitis before periodontal treatment, three months after and in a healthy control. Np GCF concentrations in the study group after treatment were significantly higher than the control group (p = 0.038). The GCF total amount (amount of substance) was significantly higher in the study group before periodontal treatment than in the control group (p = 0.001) and higher than the levels taken after treatment collection (p = 0.024). The oral fluid Np concentrations in the study group after treatment were significantly increased compared to the before treatment concentrations (p = 0.020). The same trend was observed in the urine samples. Significant correlation was found between the serum and oral fluid Np concentrations (p = 0.001, ρ = 0.40). Our results confirm the impact of cellular immunity and macrophages on periodontitis and on the resolution of periodontal inflammation. The presence of neopterin in oral fluid most likely originates in the serum.
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Kolbow H, Kiess W, Hirsch C, Vogel M, Schrock A, Elger W. The Influence of Coordinative Skills on the Oral Health of Children and Adolescents in Permanent Dentition. J Clin Med 2022; 11:jcm11216472. [PMID: 36362700 PMCID: PMC9655693 DOI: 10.3390/jcm11216472] [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: 09/29/2022] [Revised: 10/23/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Removing dental plaque by using a toothbrush is the most important measure for oral hygiene. The aim of the present study was to estimate the impact of the coordination skills of children and adolescents on their oral health (plaque level, DMF/T: decayed, missing, filled teeth). Within a prospective cohort study, 996 children (10 to 18 years) were examined. The results of three coordination tests from the Motorik Modul (MoMo) were included to evaluate the coordination skills. Other parameters taken into account were age, sex, orthodontic treatment and socioeconomic status (SES). Univariate and various multivariate analyses were performed to evaluate relationships. Better results in precision coordination tests were significantly related to a better oral hygiene (backward balancing: logistic regression OR 0.86, 95%CI: 0.73−0.99, p = 0.051, proportional odds model OR 0.86, 95%CI: 0.75−0.99, p = 0.037; one-leg-stand: logistic regression OR 0.78, 95%CI: 0.63−0.96, p = 0.018, proportional odds model OR 0.77, 95%CI: 0.64−0.92, p = 0.003). Higher scores on one-leg-stand were significantly related to a lower caries prevalence (logistic regression OR 0.81, 95%CI: 0.66−0.99, p = 0.037; Poisson regression exp(ß) 0.82, 95%CI: 0.74−0.91, p < 0.001). Coordination test under a time constraint (jumping side-to-side) showed no significant relation. Oral hygiene was poorer in younger children, boys and low SES. Caries prevalence increased with low SES and increasing age. The present results suggest that oral health is influenced by coordinative skills.
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Affiliation(s)
- Henrike Kolbow
- Department of Pediatric Dentistry, University of Leipzig, 04103 Leipzig, Germany
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Correspondence:
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research, University of Leipzig, 04103 Leipzig, Germany
| | - Christian Hirsch
- Department of Pediatric Dentistry, University of Leipzig, 04103 Leipzig, Germany
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
| | - Annett Schrock
- Department of Pediatric Dentistry, University of Leipzig, 04103 Leipzig, Germany
| | - Wieland Elger
- Department of Pediatric Dentistry, University of Leipzig, 04103 Leipzig, Germany
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
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5
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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.
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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
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6
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Deng K, Pelekos G, Jin L, Tonetti MS. Diagnostic accuracy of a point-of-care aMMP-8 test in the discrimination of periodontal health and disease. J Clin Periodontol 2021; 48:1051-1065. [PMID: 33998040 PMCID: PMC8362205 DOI: 10.1111/jcpe.13485] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/29/2021] [Accepted: 04/22/2021] [Indexed: 12/17/2022]
Abstract
Aim To assess the diagnostic utility of an oral rinse active matrix metalloproteinase‐8 (aMMP‐8) point‐of‐care test (POCT) for differentiating periodontal health, gingivitis, as well as different stages and grades of periodontitis. Materials & Methods The aMMP‐8 index test was undertaken in 408 consecutive adults, followed by a full‐mouth periodontal examination. The reference standard was the 2017 World Workshop classification of periodontal diseases. Sensitivity, specificity, and the area under the receiver operating characteristic curve (AUROC) were assessed. Results 68.6% of the participants were diagnosed with periodontitis, including Stages I (15.9%), II (15.9%), III (29.7%) and IV (7.1%). A positive aMMP‐8 POCT was associated with periodontitis after adjusting for age, gender, tobacco smoking and systemic diseases, while it was unable to differentiate among the stages/grades of periodontitis and between gingivitis/periodontal health. This test showed a sensitivity of 33.2% and a specificity of 93.0% for detecting periodontitis (threshold level >10 ng/ml). The levels of aMMP‐8 adjusted by the number of teeth present (aMMP‐8/NTP) performed better for periodontitis (sensitivity: 67.1%; specificity: 68.8%). Notably, aMMP‐8/NTP were strongly predictive for Stage IV periodontitis (threshold level =0.4312 ng/ml) (sensitivity: 89.7%; specificity: 73.6%; and AUROC: 0.856). The test performance greatly improved in combination with age and smoking, with a sensitivity of 82.5%, a specificity of 84.4%, and an AUROC of 0.883. Conclusion This aMMP‐8 POCT is able to detect periodontitis with better specificity than sensitivity across the spectrum of its severity. This test may be useful for periodontal screening in conjunction with subject characteristics and/or other sensitive screening tools. Further validation studies are needed.
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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
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7
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Kim HD, Lee CS, Cho HJ, Jeon S, Choi YN, Kim S, Kim D, Jin Lee H, Vu H, Jeong HJ, Kim B. Diagnostic ability of salivary matrix metalloproteinase-9 lateral flow test point-of-care test for periodontitis. J Clin Periodontol 2021; 47:1354-1361. [PMID: 32841379 DOI: 10.1111/jcpe.13360] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 08/03/2020] [Accepted: 08/17/2020] [Indexed: 12/20/2022]
Abstract
AIM This cross-sectional study aimed to examine the diagnostic ability of salivary matrix metalloproteinase (MMP)-9 lateral flow test (LFT) point-of-care (POC) kit and develop an algorithm for diagnosis of periodontitis. MATERIALS AND METHODS Through Seoul National Dental Hospital, 137 participants (46 LFT negatives, 91 LFT positives) were recruited. For salivary diagnostics, 150 μl of the unstimulated saliva was applied to LFT-POC kit. To make a diagnosis of periodontitis, stage II-IV in modified new international classification system was used. Covariates encompassing age, sex, smoking and obesity were evaluated through face-to-face interview. Enzyme-linked immunosorbent assay was used for quantification of salivary MMP-9. To develop a diagnostic algorithm, multivariable logistic regression analysis was used. Receiver operating characteristic curve was applied for evaluating diagnostic ability. RESULTS Diagnostic ability of salivary MMP-9 LFT-POC test was 0.82 (sensitivity of 0.92, specificity of 0.72) in total participants. Diagnostic algorithm using POC test resulted in a response equation, that is algorithm score = -3.675 + 2.877*LFT + 0.034*age + 0.121*sex + 0.372*smoking + 0.192*obesity. Diagnostic ability of the algorithm was 0.88 (sensitivity of 0.92, specificity of 0.85) with cut-off score of 0.589. CONCLUSIONS Salivary MMP-9 LFT-POC kit showed appropriate diagnostic ability for periodontitis and would be an efficient tool for screening of periodontitis.
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Affiliation(s)
- Hyun-Duck Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Chang-Soo Lee
- Department of Chemical Engineering, College of Engineering, Chungnam National University, Daejeon, Korea
| | - Hyun-Jae Cho
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Sumin Jeon
- Dental Research Institute, Seoul National University, Seoul, Korea.,Department of Oral Biology and Immunology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Young-Nim Choi
- Dental Research Institute, Seoul National University, Seoul, Korea.,Department of Oral Biology and Immunology, School of Dentistry, Seoul National University, Seoul, Korea
| | - SungTae Kim
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Korea
| | - DanHee Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyun Jin Lee
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
| | - Huong Vu
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hee-Jin Jeong
- Department of Bio and Chemical Engineering, HongIk University, Sejong-Si, Korea
| | - ByungGee Kim
- School of Chemical and Biological Engineering, Seoul National University, Seoul, Korea
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Elger W, Illge C, Kiess W, Körner A, Kratzsch J, Schrock A, Hirsch C. Relationship between deciduous molar hypomineralisation and parameters of bone metabolism in preschool children. Int Dent J 2020; 70:303-307. [PMID: 32043580 DOI: 10.1111/idj.12550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/24/2019] [Accepted: 12/02/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The aetiology of deciduous molar hypomineralisation (DMH) is still largely unknown. AIM The aim of the study was to elucidate the occurrence of DMH as a function of the parameters of bone metabolism, as it is suspected that abnormalities in these parameters may affect the mineralisation of teeth. DESIGN In a prospective cohort study, 958 children aged 1-6 years were examined. The inclusion criteria were: a blood sample to determine the parameters of bone metabolism; and documentation of enamel mineralisation using the European Academy of Paediatric Dentistry (EAPD) criteria. Multivariable methods were applied to analyse the incidence of DMH relative to the concentrations of serum calcium, phosphate, vitamin D, vitamin B12 and alkaline phosphatase, taking into account the effects of age, gender and height. RESULTS The proportion of children diagnosed with DMH was 4.0% (38 of 958). A significant difference between DMH-affected and non-DMH-affected children was found only in the serum concentration of calcium (2.47 ± 0.08 mmol/l vs. 2.52 ± 0.10 mmol/l, respectively, P = 0.004). The risk of DMH significantly increased, by 1.63-fold (95% CI: 1.03-2.57), if the calcium level dropped by 0.1 mmol/l, regardless of age, gender or adjusted height. During the follow-up examination of 17 DMH-affected subjects, the calcium level remained consistently low 1 year later (t-test, P > 0.05). CONCLUSION Children with DMH showed consistently subclinically lower serum calcium levels. No associations were found for other parameters.
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Affiliation(s)
- Wieland Elger
- Department of Pediatric Dentistry, University of Leipzig, Leipzig, Germany.,LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Christina Illge
- Department of Pediatric Dentistry, University of Leipzig, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Leipzig, Germany
| | - Antje Körner
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Leipzig, Germany
| | - Jürgen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Annett Schrock
- Department of Pediatric Dentistry, University of Leipzig, Leipzig, Germany
| | - Christian Hirsch
- Department of Pediatric Dentistry, University of Leipzig, Leipzig, Germany.,LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
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9
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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]
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10
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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.
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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.
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11
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Elger W, Kiess W, Körner A, Schrock A, Vogel M, Hirsch C. Influence of overweight/obesity, socioeconomic status, and oral hygiene on caries in primary dentition. ACTA ACUST UNITED AC 2019; 10:e12394. [DOI: 10.1111/jicd.12394] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/10/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Wieland Elger
- Department of Pediatric DentistryUniversity of Leipzig Leipzig Germany
- LIFE Leipzig Research Center for Civilization DiseasesUniversity of Leipzig Leipzig Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization DiseasesUniversity of Leipzig Leipzig Germany
- Department of Women and Child HealthHospital for Children and Adolescents and Center for Pediatric ResearchUniversity of Leipzig Leipzig Germany
| | - Antje Körner
- LIFE Leipzig Research Center for Civilization DiseasesUniversity of Leipzig Leipzig Germany
- Department of Women and Child HealthHospital for Children and Adolescents and Center for Pediatric ResearchUniversity of Leipzig Leipzig Germany
- Integrated Research and Treatment Center Adiposity DiseasesUniversity of Leipzig Leipzig Germany
| | - Annett Schrock
- Department of Pediatric DentistryUniversity of Leipzig Leipzig Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization DiseasesUniversity of Leipzig Leipzig Germany
| | - Christian Hirsch
- Department of Pediatric DentistryUniversity of Leipzig Leipzig Germany
- LIFE Leipzig Research Center for Civilization DiseasesUniversity of Leipzig Leipzig Germany
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Schmidt J, Strecker P, Kreuz M, Löffler M, Kiess W, Hirsch C, Thiery J, Baber R, Bae YJ, Kratzsch J, Haak R, Ziebolz D. Stress-related hormones in association with periodontal condition in adolescents-results of the epidemiologic LIFE Child study. Clin Oral Investig 2018; 23:1793-1802. [PMID: 30187257 DOI: 10.1007/s00784-018-2599-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/20/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the associations between blood levels of stress-related hormones and early signs of periodontal disease in children and adolescents. MATERIALS AND METHODS Within the LIFE (Leipzig research center for civilization diseases) Child study, 498 adolescents (10 to 18 years) were included. Early signs of periodontal inflammation were measured by probing depth (PD) at six index teeth (16, 11, 26, 36, 31, 46). Blood levels of stress-related hormones (cortisol, dehydroepiandosterone-sulfate [DHEA-S]) and, additionally interleukine-6 (IL-6) were measured. Socioeconomic status, oral hygiene, orthodontic appliances, and nutritional status, recorded by body-mass-index-standard-deviation-score (BMI-SDS), were considered as confounding factors. Additionally, in 98 participants, an oral chairside active matrix metalloproteinase-8 (aMMP-8) test was performed. Statistical tests are the Mann-Whitney U tests, chi-squared tests and multivariate logistic regression model. RESULTS IL-6, BMI-SDS as well as positive aMMP-8 test result were significantly associated with maximum PD > 3 mm (p < 0.05). However, no statistically significant associations between stress-related hormones (cortisol and DHEA-S) and presence of maximum PD > 3 mm were found (p > 0.05). Higher DHEA-S and BMI were associated with positive aMMP-8 result, even after adjusting for age and gender (p = 0.027, padj = 0.026). CONCLUSION The results reveal no associations between PD and stress-related hormones cortisol and DHEA-S. aMMP-8 test result might be associated with DHEA-S level. Nutritional status seems to influence periodontal disease in adolescents. CLINICAL RELEVANCE DHEA-S and BMI-SDS show associations with early signs of periodontal disease in adolescents aged 10 to 18 years. This association should be confirmed by the investigation of high-risk groups.
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Affiliation(s)
- Jana Schmidt
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany
| | - Pia Strecker
- 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
| | - Joachim Thiery
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List-Strasse 13/15, 04103, Leipzig, Germany
| | - Ronny Baber
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103, Leipzig, Germany.,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List-Strasse 13/15, 04103, Leipzig, Germany
| | - Yoon Ju Bae
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List-Strasse 13/15, 04103, Leipzig, Germany
| | - Jürgen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List-Strasse 13/15, 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany.
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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.
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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
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