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Ebersole JL, Hasturk H, Huber M, Gellibolian R, Markaryan A, Zhang XD, Miller CS. Realizing the clinical utility of saliva for monitoring oral diseases. Periodontol 2000 2024. [PMID: 39010260 DOI: 10.1111/prd.12581] [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: 03/18/2024] [Revised: 05/01/2024] [Accepted: 05/16/2024] [Indexed: 07/17/2024]
Abstract
In the era of personalized/precision health care, additional effort is being expended to understand the biology and molecular mechanisms of disease processes. How these mechanisms are affected by individual genetics, environmental exposures, and behavioral choices will encompass an expanding role in the future of optimally preventing and treating diseases. Considering saliva as an important biological fluid for analysis to inform oral disease detection/description continues to expand. This review provides an overview of saliva as a diagnostic fluid and the features of various biomarkers that have been reported. We emphasize the use of salivary biomarkers in periodontitis and transport the reader through extant literature, gaps in knowledge, and a structured approach toward validating and determine the utility of biomarkers in periodontitis. A summation of the findings support the likelihood that a panel of biomarkers including both host molecules and specific microorganisms will be required to most effectively identify risk for early transition to disease, ongoing disease activity, progression, and likelihood of response to standard periodontal therapy. The goals would be to develop predictive algorithms that serve as adjunctive diagnostic tools which provide the clinician and patient important information for making informed clinical decisions.
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Affiliation(s)
- Jeffrey L Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Hatice Hasturk
- Immunology and Inflammation, Center for Clinical and Translational Research, The ADA Forsyth Institute, Cambridge, Massachusetts, USA
| | - Michaell Huber
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | | | | | - Xiaohua D Zhang
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Craig S Miller
- Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
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2
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Ahmad P, Siqueira WL. Polymorphism of salivary proteins and risk of periodontal diseases: A systematic review and meta-analysis of clinical studies. J Dent 2024; 141:104804. [PMID: 38122885 DOI: 10.1016/j.jdent.2023.104804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/17/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES The present systematic review and meta-analysis aimed to assess the association between salivary protein polymorphisms and the risk of periodontal diseases (PD). DATA The review incorporated cross-sectional, case-control, retrospective/prospective cohort, and randomized controlled trials assessing the influence of salivary protein polymorphisms on the risk of PD development were included in this review. SOURCES A thorough literature search was conducted across electronic databases, namely PubMed, Scopus, Embase, and Web of Science, without any restrictions on publication language and year. STUDY SELECTION A total of 168 studies were identified, of which 19 were eligible for inclusion. The risk of bias (RoB) assessment of the included studies was conducted at the methodological level. RESULTS A total of 16 studies were included. Polymorphism in the gene encoding TNF-α was found to be protective against gingivitis, while those encoding IL-1α and IL-1β were associated with developing gingivitis. Of the 42 proteins investigated, various gene polymorphisms were identified as protective or risk factors for periodontitis. Protective genes include CFH, DNMT1, OPRM1, and TLR9. Conversely, certain salivary protein genes (e.g., CRP, ERN1, FAM5C, IDH2, LTA, TET2, MPA, NLRP3, TLR4) were associated with periodontitis risk. Notably, IL6, MMP9, and MUC7 genes showed no association with PD, while MMP13 was linked to early implant loss. Overall, the meta-analysis found a statistically significant association between salivary proteins' polymorphisms and risk of PD. CONCLUSIONS Salivary protein polymorphisms significantly influence PD, revealing protective and risk-associated genotypes. Despite limitations, findings suggest therapeutic targets, emphasizing the complex genetics-periodontal health interplay. CLINICAL SIGNIFICANCE This study unveils salivary protein polymorphisms as pivotal factors in PD. Protective genes including CFH and TLR9, and risk-associated genes including CRP and TLR4, indicate a genetic basis for PD susceptibility.
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Affiliation(s)
- Paras Ahmad
- College of Dentistry, University of Saskatchewan, Saskatoon, S7N E5E, Saskatchewan, Canada
| | - Walter Luiz Siqueira
- College of Dentistry, University of Saskatchewan, Saskatoon, S7N E5E, Saskatchewan, Canada.
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3
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Ali Alftaikhah SA, Issrani R, Alnasser M, Almutairi HA, Khattak O, Iqbal A, Prabhu N. Salivary Biomarkers in Periodontitis: A Scoping Review. Cureus 2023; 15:e50207. [PMID: 38192959 PMCID: PMC10772482 DOI: 10.7759/cureus.50207] [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] [Accepted: 12/08/2023] [Indexed: 01/10/2024] Open
Abstract
Periodontal disease is a prevalent and potentially impactful oral health condition, ranging from gingivitis to severe periodontitis. Early detection and precise management are crucial in modern dentistry due to its prevalence and potential systemic health implications. Traditional clinical assessments and radiographic imaging have been the primary diagnostic tools. However, recent advances in oral diagnostics have introduced the concept of non-invasive, easily accessible salivary biomarkers. This review explores the evolving landscape of salivary biomarkers associated with periodontal disease, offering a comprehensive analysis of recent studies. It delves into the key findings, clinical significance, and potential impact of these biomarkers in revolutionizing periodontal disease diagnostics and treatment monitoring. The study emphasizes their diagnostic and prognostic capabilities, including their ability to assess disease severity, correlate with clinical parameters, aid in early detection, and enhance personalized treatment planning. As the field of oral diagnostics continues to advance, understanding the role of salivary biomarkers in periodontal disease management holds the promise of improving precision and effectiveness in oral healthcare. This review underscores the potential for salivary biomarkers to become integral components of routine periodontal care, offering a minimally invasive and patient-centered approach to oral health management.
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Affiliation(s)
| | - Rakhi Issrani
- Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, SAU
- Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Muhsen Alnasser
- Restorative Dental Sciences, College of Dentistry, Jouf University, Sakaka, SAU
| | | | - Osama Khattak
- Restorative Dental Sciences, College of Dentistry, Jouf University, Sakakah, SAU
| | - Azhar Iqbal
- Restorative Dental Sciences, College of Dentistry, Jouf University, Sakakah, SAU
| | - Namdeo Prabhu
- Oral and Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, SAU
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Sami A, Elimairi I, Ryan CA, Stanton C, Patangia D, Ross RP. Altered oral microbiome in Sudanese Toombak smokeless tobacco users carries a newly emerging risk of squamous cell carcinoma development and progression. Sci Rep 2023; 13:6645. [PMID: 37095112 PMCID: PMC10125980 DOI: 10.1038/s41598-023-32892-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/04/2023] [Indexed: 04/26/2023] Open
Abstract
There are an estimated 6-10 million smokeless tobacco (Toombak) users in Sudan, the majority being males. Toombak is known to be a carcinogenic product that is likely to modify the oral microbiome spatiality into a high-risk potential for the development and progression of oral cancer, but previous studies are lacking in this field. Here, we endeavour for the first time the exploration of the oral microbiome in key mucosal areas of the oral cavity and assess the microbiome variations in premalignant and oral squamous cell carcinoma (OSCC) samples from both users and non-users of Toombak. 16S rRNA sequencing was performed on DNA obtained from pooled saliva, oral mucosa and supragingival plaque from 78 Sudanese users and non-users of Toombak, aged between 20 and 70 years. In 32 of the pooled saliva samples, the mycobiome (fungal) environment was analysed through ITS sequencing. Then, 46 formalin-fixed paraffin-embedded samples of premalignant and OSCC samples were collected, and their associated microbiomes sequenced. The oral Sudanese microbiome was found to be enriched in Streptococcaceae, but Staphylococcaceae were significantly more abundant amongst Toombak users. Genera enriched in the oral cavity of Toombak users included Corynebacterium_1 and Cardiobacterium while in non-users, Prevotella, Lactobacillus and Bifidobacterium were prominent. Aspergillus was the most abundant fungus in the mouths of Toombak users with a marked loss of Candida. The genus Corynebacterium_1 was abundant in the buccal, floor of the mouth and saliva microbiomes as well as in oral cancer samples from Toombak users indicating a possible role for this genus in the early stages of oral cancer development. An oral cancer microbiome that favours poor survival and metastasis in those who use Toombak also emerged that includes the genera Stenotrophomonas and Schlegelella. Those utilising Toombak carry an altered oral microbiome that may be an additional risk factor for this products carcinogenicity to the oral structures. These significant microbiome modulations are a newly emerging key driving factor in oral cancer development and progression in Toombak users while it is also shown that Toombak users carry an oral cancer microbiome that may increase the potential for a poorer prognosis.
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Affiliation(s)
- Amel Sami
- APC Microbiome Ireland, School of Microbiology, University College Cork, Cork, T12 YN60, Ireland
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Dentistry, National Ribat University, Nile street, 1111, Khartoum, Sudan
| | - Imad Elimairi
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Dentistry, National Ribat University, Nile street, 1111, Khartoum, Sudan
| | - C Anthony Ryan
- Department of Paediatrics and Child Health, University College Cork, Cork, T12 DFK4, Ireland
| | - Catherine Stanton
- APC Microbiome Ireland, School of Microbiology, University College Cork, Cork, T12 YN60, Ireland.
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork, P61 C996, Ireland.
| | - Dhrati Patangia
- APC Microbiome Ireland, School of Microbiology, University College Cork, Cork, T12 YN60, Ireland
| | - R Paul Ross
- APC Microbiome Ireland, School of Microbiology, University College Cork, Cork, T12 YN60, Ireland
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Hall MW, Wellappuli NC, Huang RC, Wu K, Lam DK, Glogauer M, Beiko RG, Senadheera DB. Suspension of oral hygiene practices highlights key bacterial shifts in saliva, tongue, and tooth plaque during gingival inflammation and resolution. ISME COMMUNICATIONS 2023; 3:23. [PMID: 36966246 PMCID: PMC10039884 DOI: 10.1038/s43705-023-00229-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/06/2023] [Accepted: 03/02/2023] [Indexed: 03/27/2023]
Abstract
Experimentally induced gingivitis is associated with inflammatory and microbiological changes in an otherwise healthy subject, demonstrating the impacts of discontinuing oral hygiene routines. Understanding the bacterial dynamics during the induction and resolution of gingival inflammation will aid in the development of bacterial prognostic tests and probiotics for severe oral disease. We profiled the bacterial community in 15 healthy subjects who suspended all oral-hygiene practices for three weeks. Saliva, tongue, subgingival, and supragingival plaque samples were collected over seven weeks and showed a return to community baseline after oral hygiene practices were resumed. Stronger temporal changes in subgingival and supragingival plaque suggest these sample types may be preferred over saliva or tongue plaque for future prognostics. Taxonomic groups spanning ten phyla demonstrated consistent abundance shifts, including a significant decrease in Streptococcus, Neisseria, and Actinomyces populations, and an increase in Prevotella, Fusobacterium, and Porphyromonas populations. With four distinct oral sites surveyed and results mapped to the Human Oral Microbiome Database reference set, this work provides a comprehensive taxonomic catalog of the bacterial shifts observed during the onset and resolution of gingival inflammation.
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Affiliation(s)
| | | | - Ruo Chen Huang
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Kay Wu
- McMaster University, Hamilton, ON, Canada
| | | | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
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Huang Z, Yang X, Huang Y, Tang Z, Chen Y, Liu H, Huang M, Qing L, Li L, Wang Q, Jie Z, Jin X, Jia B. Saliva - a new opportunity for fluid biopsy. Clin Chem Lab Med 2023; 61:4-32. [PMID: 36285724 DOI: 10.1515/cclm-2022-0793] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/29/2022] [Indexed: 12/15/2022]
Abstract
Saliva is a complex biological fluid with a variety of biomolecules, such as DNA, RNA, proteins, metabolites and microbiota, which can be used for the screening and diagnosis of many diseases. In addition, saliva has the characteristics of simple collection, non-invasive and convenient storage, which gives it the potential to replace blood as a new main body of fluid biopsy, and it is an excellent biological diagnostic fluid. This review integrates recent studies and summarizes the research contents of salivaomics and the research progress of saliva in early diagnosis of oral and systemic diseases. This review aims to explore the value and prospect of saliva diagnosis in clinical application.
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Affiliation(s)
- Zhijie Huang
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Xiaoxia Yang
- Department of Endodontics, Stomatological Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Yisheng Huang
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Zhengming Tang
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Yuanxin Chen
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Hongyu Liu
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Mingshu Huang
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Ling Qing
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Li Li
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Qin Wang
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Zhuye Jie
- BGI Genomics, BGI-Shenzhen, Shenzhen, P.R. China
- Shenzhen Key Laboratory of Human Commensal Microorganisms and Health Research, BGI-Shenzhen, Shenzhen, P.R. China
- Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Xin Jin
- BGI Genomics, BGI-Shenzhen, Shenzhen, P.R. China
- School of Medicine, South China University of Technology, Guangzhou, P.R. China
| | - Bo Jia
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P.R. China
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7
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Changes in salivary biomarkers associated with periodontitis and diabetic neuropathy in individuals with type 1 diabetes. Sci Rep 2022; 12:11284. [PMID: 35788667 PMCID: PMC9253002 DOI: 10.1038/s41598-022-15430-0] [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: 02/14/2022] [Accepted: 06/23/2022] [Indexed: 11/08/2022] Open
Abstract
The objective of this pilot clinical study was to identify salivary biomarkers that are associated with periodontal disease and measures of diabetic autonomic dysfunction. Saliva samples from 32 participants were obtained from 3 groups: healthy (H), type 1 diabetes mellitus (DM), and type 1 diabetes mellitus with neuropathy (DMN). Based on the periodontal examination, individuals’ mean Periodontal Screening and Recording scores were categorized into two groups (periodontally healthy and gingivitis), and correlated to specific salivary inflammatory biomarkers assessed by a customized protein array and enzyme assay. The mean salivary IgA level in DM was 9211.5 ± 4776.4 pg/ml, which was significantly lower than H (17,182.2 ± 8899.3 pg/ml). IgA in DMN with healthy periodontium was significantly lower (5905.5 ± 3124.8 pg/ml) compared to H, although IgA levels in DMN patients with gingivitis (16,894. 6 ± 7084.3) were not. According to the result of a logistic regression model, IgA and periodontal condition were the indicators of the binary response given by H versus DM, and H versus DMN, respectively. These data suggest that selected salivary biomarkers, such as IgA, combined with a periodontal examination prior to obtaining salivary samples can offer a non-invasive method to assess risk for developing diabetic neuropathy.
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Haririan H, Andrukhov O, Laky M, Rausch-Fan X. Saliva as a Source of Biomarkers for Periodontitis and Periimplantitis. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.687638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Saliva has the potential to be used as a diagnostic and monitoring tool for various diseases if biomarkers of an adequate sensitivity and specificity could be identified. Several reviews and even meta-analyses have been performed in recent years, which have found some candidate biomarkers for periodontitis, like macrophage inflammatory protein-1 alpha, interleukin-1ß, interleukin-6, matrix metalloproteinase-8, or hemoglobin. However, none of those are currently in use to replace conventional periodontal diagnostics with a periodontal probe. For periimplantitis, to date, heterogeneity of different study protocols and implant types did not permit to discover clear biomarkers, which were able to distinguish between healthy and diseased implants. Few proinflammatory cytokines, similar to periodontitis, have been characterized as adjunct tools to clinical diagnosis. The additional determination of antimicrobial peptides, bone turnover markers, and bacteria could help to enhance sensitivity and specificity in a combined model for periodontitis and periimplantitis. Furthermore, proteomic approaches might be preferred over single biomarker determinations. A global consensus is also needed to harmonize salivary sampling methods as well as procedures of biomarker analysis to ensure future comparability.
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The Potential Impact of Salivary IL-1 on the Diagnosis of Periodontal Disease: A Pilot Study. Healthcare (Basel) 2021; 9:healthcare9060729. [PMID: 34199256 PMCID: PMC8231867 DOI: 10.3390/healthcare9060729] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/11/2021] [Accepted: 06/11/2021] [Indexed: 12/29/2022] Open
Abstract
The aim of this study was to identify inflammatory cytokines as salivary biomarkers for periodontal disease. The subjects were 33 Korean adults aged 23 to 71 years. Using a multiplexed bead immunoassay called Luminex, the levels of inflammatory cytokines related to periodontal disease were evaluated. Oral examination for periodontal disease and gingival bleeding was conducted. With these two independent variables, differences in inflammatory cytokines were analyzed by an independent t-test and age-adjusted ANCOVA. Among the subjects, 21 had periodontal disease and 12 were healthy subjects. The gingival bleeding status was classified into low and high levels. Among 13 inflammatory cytokines in saliva, IL-1α, IL-1β, IL-4, IL-8, CCL2/MCP-1, CCL3/MIP-1α, and TNF-α were found to be significant biomarkers within the standard curve. The quantity of IL-1β was increased in subjects with high levels of gingival bleeding. IL-1α levels were increased in subjects with periodontal disease. After adjusting for age, the significant biomarkers for gingival bleeding and periodontal disease were IL-1β and IL-1α, respectively. Using the receiver operating characteristic (ROC) curve, IL-1β was confirmed as a significant biomarker. The sensitivity and specificity of IL-1β for predicting periodontitis were 88.24% and 62.5%, respectively. Therefore, IL-1 was found to be a significant biomarker for periodontal disease, and it could be used in the diagnosis of periodontal disease using saliva.
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10
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Validation and verification of predictive salivary biomarkers for oral health. Sci Rep 2021; 11:6406. [PMID: 33742017 PMCID: PMC7979790 DOI: 10.1038/s41598-021-85120-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 02/24/2021] [Indexed: 02/06/2023] Open
Abstract
Oral health is important not only due to the diseases emerging in the oral cavity but also due to the direct relation to systemic health. Thus, early and accurate characterization of the oral health status is of utmost importance. There are several salivary biomarkers as candidates for gingivitis and periodontitis, which are major oral health threats, affecting the gums. These need to be verified and validated for their potential use as differentiators of health, gingivitis and periodontitis status, before they are translated to chair-side for diagnostics and personalized monitoring. We aimed to measure 10 candidates using high sensitivity ELISAs in a well-controlled cohort of 127 individuals from three groups: periodontitis (60), gingivitis (31) and healthy (36). The statistical approaches included univariate statistical tests, receiver operating characteristic curves (ROC) with the corresponding Area Under the Curve (AUC) and Classification and Regression Tree (CART) analysis. The main outcomes were that the combination of multiple biomarker assays, rather than the use of single ones, can offer a predictive accuracy of > 90% for gingivitis versus health groups; and 100% for periodontitis versus health and periodontitis versus gingivitis groups. Furthermore, ratios of biomarkers MMP-8, MMP-9 and TIMP-1 were also proven to be powerful differentiating values compared to the single biomarkers.
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Baima G, Iaderosa G, Citterio F, Grossi S, Romano F, Berta GN, Buduneli N, Aimetti M. Salivary metabolomics for the diagnosis of periodontal diseases: a systematic review with methodological quality assessment. Metabolomics 2021; 17:1. [PMID: 33387070 DOI: 10.1007/s11306-020-01754-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/30/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Early diagnosis of periodontitis by means of a rapid, accurate and non-invasive method is highly desirable to reduce the individual and epidemiological burden of this largely prevalent disease. OBJECTIVES The aims of the present systematic review were to examine potential salivary metabolic biomarkers and pathways associated to periodontitis, and to assess the accuracy of salivary untargeted metabolomics for the diagnosis of periodontal diseases. METHODS Relevant studies identified from MEDLINE (PubMed), Embase and Scopus databases were systematically examined for analytical protocols, metabolic biomarkers and results from the multivariate analysis (MVA). Pathway analysis was performed using the MetaboAnalyst online software and quality assessment by means of a modified version of the QUADOMICS tool. RESULTS Twelve studies met the inclusion criteria, with sample sizes ranging from 19 to 130 subjects. Compared to periodontally healthy individuals, valine, phenylalanine, isoleucine, tyrosine and butyrate were found upregulated in periodontitis patients in most studies; while lactate, pyruvate and N-acetyl groups were the most significantly expressed in healthy individuals. Metabolic pathways that resulted dysregulated are mainly implicated in inflammation, oxidative stress, immune activation and bacterial energetic metabolism. The findings from MVA revealed that periodontitis is characterized by a specific metabolic signature in saliva, with coefficients of determination ranging from 0.52 to 0.99. CONCLUSIONS This systematic review summarizes candidate metabolic biomarkers and pathways related to periodontitis, which may provide opportunities for the validation of diagnostic or predictive models and the discovery of novel targets for monitoring and treating such a disease (PROSPERO CRD42020188482).
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Affiliation(s)
- Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy.
| | - Giovanni Iaderosa
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Silvia Grossi
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Giovanni N Berta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Nurcan Buduneli
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
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Steigmann L, Maekawa S, Sima C, Travan S, Wang CW, Giannobile WV. Biosensor and Lab-on-a-chip Biomarker-identifying Technologies for Oral and Periodontal Diseases. Front Pharmacol 2020; 11:588480. [PMID: 33343358 PMCID: PMC7748088 DOI: 10.3389/fphar.2020.588480] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/23/2020] [Indexed: 12/16/2022] Open
Abstract
Periodontitis is a complex multifactorial disease that can lead to destruction of tooth supporting tissues and subsequent tooth loss. The most recent global burden of disease studies highlight that severe periodontitis is one of the most prevalent chronic inflammatory conditions affecting humans. Periodontitis risk is attributed to genetics, host-microbiome and environmental factors. Empirical diagnostic and prognostic systems have yet to be validated in the field of periodontics. Early diagnosis and intervention prevents periodontitis progression in most patients. Increased susceptibility and suboptimal control of modifiable risk factors can result in poor response to therapy, and relapse. The chronic immune-inflammatory response to microbial biofilms at the tooth or dental implant surface is associated with systemic conditions such as cardiovascular disease, diabetes or gastrointestinal diseases. Oral fluid-based biomarkers have demonstrated easy accessibility and potential as diagnostics for oral and systemic diseases, including the identification of SARS-CoV-2 in saliva. Advances in biotechnology have led to innovations in lab-on-a-chip and biosensors to interface with oral-based biomarker assessment. This review highlights new developments in oral biomarker discovery and their validation for clinical application to advance precision oral medicine through improved diagnosis, prognosis and patient stratification. Their potential to improve clinical outcomes of periodontitis and associated chronic conditions will benefit the dental and overall public health.
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Affiliation(s)
- Larissa Steigmann
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Shogo Maekawa
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States.,Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Corneliu Sima
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - Suncica Travan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Chin-Wei Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - William V Giannobile
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States.,Biointerfaces Institute and Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, United States
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Zheng Y, Chai L, Fan Y, Song YQ, Zee KY, Tu WW, Jin L, Leung WK. Th2 cell regulatory and effector molecules single nucleotide polymorphisms and periodontitis. J Leukoc Biol 2020; 108:1641-1654. [PMID: 32745291 DOI: 10.1002/jlb.4ma0720-698rr] [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: 01/27/2020] [Revised: 07/12/2020] [Accepted: 07/19/2020] [Indexed: 11/07/2022] Open
Abstract
To investigate the association between T helper 2 (Th2) cell regulatory and effector molecules' genetic polymorphisms and periodontitis. Single nucleotide polymorphisms (SNPs) of 11 Th2 cell regulatory or effector molecules genes (CD28, CTLA4, IL4, IL5, IL6, IL9, IL10, IL13, IL4R, GATA3, STAT6, and rs1537415; total 130 SNPs) were studied in Chinese nonsmokers (163 periodontitis-free controls, 141 periodontitis patients) using Sequenom iPlex assays. SNPs potentially associated with periodontitis (adjusted allelic P < 0.1) in this cross-sectional study were further investigated via meta-analysis. Allele G of rs4553808 in promoter of CTLA4 was more frequently detected in periodontitis than controls (P < 0.005), but did not remain significant after age and gender adjustment. Haplotype (GTT) in a block of three CTLA4 SNPs (rs4553808, rs16840252, rs5742909) was significantly associated with periodontitis. Meta-analysis of SNPs identified indicated allele T of CTLA4 rs5742909 (3 studies; 461 control, 369 periodontitis) and allele G of IL6 rs1800796 (18 studies; 2760 control, 2442 periodontitis) were significantly associated with periodontitis (OR = 1.44 and OR = 1.30, respectively). Within limitations of this study, a haplotype of CTLA4 concerning Th2 cell regulation, may be associated with periodontitis in Chinese nonsmokers followed. Meta-analysis indicated rs5742909 of CTLA4 and rs1800796 of IL6 appeared significantly associated with periodontitis.
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Affiliation(s)
- Ying Zheng
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Lei Chai
- Rytime Dental Hospital, Chengdu, Sichuan, China
| | - Yanhui Fan
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Current address: Phil Rivers Technology, Nanshan District, Haitian Second Road, Shenzhen, China
| | - You-Qiang Song
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kwan-Yat Zee
- Thornleigh Periodontal Clinic, Thornleigh, New South Wales, Australia
| | - Wen Wei Tu
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Lijian Jin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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14
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Trombelli L, Farina R, Silva CO, Tatakis DN. Plaque-induced gingivitis: Case definition and diagnostic considerations. J Periodontol 2019; 89 Suppl 1:S46-S73. [PMID: 29926936 DOI: 10.1002/jper.17-0576] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/15/2017] [Accepted: 10/21/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Clinical gingival inflammation is a well-defined site-specific condition for which several measurement systems have been proposed and validated, and epidemiological studies consistently indicate its high prevalence globally. However, it is clear that defining and grading a gingival inflammatory condition at a site level (i.e. a "gingivitis site") is completely different from defining and grading a "gingivitis case" (GC) (i.e. a patient affected by gingivitis), and that a "gingivitis site" does not necessarily mean a "GC". The purpose of the present review is to summarize the evidence on clinical, biochemical, microbiologic, genetic markers as well as symptoms associated with plaque-induced gingivitis and to propose a set of criteria to define GC. IMPORTANCE A universally accepted case definition for gingivitis would provide the necessary information to enable oral health professionals to assess the effectiveness of their prevention strategies and treatment regimens; help set priorities for therapeutic actions/programs by health care providers; and undertake surveillance. FINDINGS Based on available methods to assess gingival inflammation, GC could be simply, objectively and accurately identified and graded using bleeding on probing score (BOP%) CONCLUSIONS: A patient with intact periodontium would be diagnosed as a GC according to a BOP score ≥ 10%, further classified as localized (BOP score ≥ 10% and ≤30%) or generalized (BOP score > 30%). The proposed classification may also apply to patients with a reduced periodontium, where a GC would characterize a patient with attachment loss and BOP score ≥ 10%, but without BOP in any site probing ≥4 mm in depth.
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Affiliation(s)
- Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Cléverson O Silva
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
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15
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Zheng LY, Rifkin BR, Spielman AI, London L, London SD. The Teaching of Personalized Dentistry in North American Dental Schools: Changes from 2014 to 2017. J Dent Educ 2019; 83:1065-1075. [DOI: 10.21815/jde.019.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 03/22/2019] [Indexed: 01/04/2023]
Affiliation(s)
| | - Barry R. Rifkin
- Oral Biology and Pathology; School of Dental Medicine; Stony Brook University; New York University
| | - Andrew I. Spielman
- Department of Basic Science and Craniofacial Biology; College of Dentistry; New York University
| | - Lucille London
- Oral Biology and Pathology; School of Dental Medicine; Stony Brook University
| | - Steven D. London
- Oral Biology and Pathology; School of Dental Medicine; Stony Brook University
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16
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Nagarajan R, Miller CS, Dawson D, Ebersole JL. Biologic modelling of periodontal disease progression. J Clin Periodontol 2019; 46:160-169. [DOI: 10.1111/jcpe.13064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 12/03/2018] [Accepted: 01/05/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Radhakrishnan Nagarajan
- Division of Biomedical Informatics College of Medicine University of Kentucky Lexington Kentucky
| | - Craig S. Miller
- Division of Oral Diagnosis, Oral Medicine and Oral Radiology University of Kentucky Lexington Kentucky
- Center for Oral Health Research College of Dentistry University of Kentucky Lexington Kentucky
| | - Dolph Dawson
- Center for Oral Health Research College of Dentistry University of Kentucky Lexington Kentucky
- Division of Periodontics University of Kentucky Lexington Kentucky
| | - Jeffrey L. Ebersole
- Center for Oral Health Research College of Dentistry University of Kentucky Lexington Kentucky
- Department of Biomedical Sciences School of Dental Medicine University of Nevada Las Vegas Las Vegas Nevada
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17
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Romano F, Meoni G, Manavella V, Baima G, Mariani GM, Cacciatore S, Tenori L, Aimetti M. Effect of non-surgical periodontal therapy on salivary metabolic fingerprint of generalized chronic periodontitis using nuclear magnetic resonance spectroscopy. Arch Oral Biol 2018; 97:208-214. [PMID: 30396039 DOI: 10.1016/j.archoralbio.2018.10.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/06/2018] [Accepted: 10/21/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Metabolomic analysis of saliva proved its accuracy in discriminating patients with generalized chronic periodontitis (GCP) from healthy subjects by identifying specific molecular signatures of the disease. There is lack of investigations concerning the effect of periodontal treatment on individual metabolic fingerprints. Therefore, the aim of this study was to determine whether non-surgical periodontal therapy could change salivary metabolomic profile in GCP to one more similar to periodontal health. DESIGN Unstimulated whole saliva of 32 controls and 19 GCP patients were obtained prior to and 3 months after conventional staged non-surgical periodontal therapy. Metabolic profiling was performed using Nuclear Magnetic Resonance (NMR) spectroscopy, followed by univariate and multivariate paired approaches to assess the changes introduced by the therapy. RESULTS In GCP group, periodontal treatment led to an improvement in all clinical parameters (p < 0.001). The accuracy of the multivariate model in discriminating the metabolomic profile of each GCP patient at two time points was 92.5%. Despite the almost perfect separation of the spectra in the metabolic space, the univariate analysis failed to identify significant variations in single metabolite content. The post-treatment metabolic profile of GCP patients could not be assimilated to that of healthy controls who exhibited different levels of lactate, pyruvate, valine, proline, tyrosine, and formate. CONCLUSIONS Based on these data, NMR-spectroscopic analysis revealed that, despite significant changes in the overall metabolomic fingerprint after non-surgical therapy, GCP patients maintained a distinctive metabolic profile compared to healthy individuals.
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Affiliation(s)
- Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Gaia Meoni
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy
| | - Valeria Manavella
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Giulia Maria Mariani
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Stefano Cacciatore
- Cancer Genomics Research Group, International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town, South Africa
| | - Leonardo Tenori
- Department of Experimental and Clinical Medicine, University of Florence, Sesto Fiorentino, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy.
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18
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Kaczor-Urbanowicz KE, Trivedi HM, Lima PO, Camargo PM, Giannobile WV, Grogan TR, Gleber-Netto FO, Whiteman Y, Li F, Lee HJ, Dharia K, Aro K, Carerras-Presas CM, Amuthan S, Vartak M, Akin D, Al-adbullah H, Bembey K, Klokkevold PR, Elashoff D, Barnes VM, Richter R, DeVizio W, Masters JG, Wong DTW. Salivary exRNA biomarkers to detect gingivitis and monitor disease regression. J Clin Periodontol 2018; 45:806-817. [PMID: 29779262 PMCID: PMC6023773 DOI: 10.1111/jcpe.12930] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 04/14/2018] [Accepted: 05/13/2018] [Indexed: 12/15/2022]
Abstract
AIM This study tests the hypothesis that salivary extracellular RNA (exRNA) biomarkers can be developed for gingivitis detection and monitoring disease regression. MATERIALS AND METHODS Salivary exRNA biomarker candidates were developed from a total of 100 gingivitis and non-gingivitis individuals using Affymetrix's expression microarrays. The top 10 differentially expressed exRNAs were tested in a clinical cohort to determine whether the discovered salivary exRNA markers for gingivitis were associated with clinical gingivitis and disease regression. For this purpose, unstimulated saliva was collected from 30 randomly selected gingivitis subjects, the gingival and plaque indexes scores were taken at baseline, 3 and 6 weeks and salivary exRNAs were assayed by means of reverse transcription quantitative polymerase chain reaction. RESULTS Eight salivary exRNA biomarkers developed for gingivitis were statistically significantly changed over time, consistent with disease regression. A panel of four salivary exRNAs [SPRR1A, lnc-TET3-2:1, FAM25A, CRCT1] can detect gingivitis with a clinical performance of 0.91 area under the curve, with 71% sensitivity and 100% specificity. CONCLUSIONS The clinical values of the developed salivary exRNA biomarkers are associated with gingivitis regression. They offer strong potential to be advanced for definitive validation and clinical laboratory development test.
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Affiliation(s)
| | - Harsh M. Trivedi
- Colgate Palmolive Co., Early Research Oral Care, New Jersey, 909
River Road, Piscataway, New Jersey, USA 08855
| | - Patricia O. Lima
- Center for Oral/Head & Neck Oncology Research, UCLA School
of Dentistry, University of California at Los Angeles, California, USA
- Department of Physiological Sciences, Piracicaba Dental School,
University of Campinas, Piracicaba, São Paulo, Brazil
| | - Paulo M. Camargo
- Section of Periodontics, UCLA School of Dentistry, University of
California at Los Angeles, California, USA
| | - William V. Giannobile
- Department of Periodontics and Oral Medicine, School of Dentistry,
University of Michigan, Ann Arbor, Michigan, USA
| | - Tristan R. Grogan
- Department of Biostatistics, University of California at Los
Angeles, California, USA
| | - Frederico O. Gleber-Netto
- Medical Genomics Laboratory, Centro Internacional de Pesquisa e
Ensino (CIPE), AC Camargo Cancer Center, São Paulo, Brazil
| | - Yair Whiteman
- Center for Esthetic Dentistry, UCLA School of Dentistry, University
of California at Los Angeles, California, USA
| | - Feng Li
- Center for Oral/Head & Neck Oncology Research, UCLA School
of Dentistry, University of California at Los Angeles, California, USA
| | - Hyo Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National
University Bundang Hospital, Seoul, Korea
| | - Karan Dharia
- UCLA School of Dentistry, University of California at Los Angeles,
California, USA
| | - Katri Aro
- Center for Oral/Head & Neck Oncology Research, UCLA School
of Dentistry, University of California at Los Angeles, California, USA
| | | | - Saarah Amuthan
- UCLA School of Dentistry, University of California at Los Angeles,
California, USA
| | - Manjiri Vartak
- UCLA School of Dentistry, University of California at Los Angeles,
California, USA
| | - David Akin
- Center for Oral/Head & Neck Oncology Research, UCLA School
of Dentistry, University of California at Los Angeles, California, USA
| | - Hiba Al-adbullah
- UCLA School of Dentistry, University of California at Los Angeles,
California, USA
| | - Kanika Bembey
- UCLA School of Dentistry, University of California at Los Angeles,
California, USA
| | - Perry R. Klokkevold
- Section of Periodontics, UCLA School of Dentistry, University of
California at Los Angeles, California, USA
| | - David Elashoff
- Department of Biostatistics, University of California at Los
Angeles, California, USA
| | - Virginia Monsul Barnes
- Colgate Palmolive Co., Clinical Research Oral Care, New Jersey, 909
River Road, Piscataway, New Jersey, USA 08855
| | - Rose Richter
- Colgate Palmolive Co., Clinical Research Oral Care, New Jersey, 909
River Road, Piscataway, New Jersey, USA 08855
| | - William DeVizio
- Colgate Palmolive Co., Clinical Research Oral Care, New Jersey, 909
River Road, Piscataway, New Jersey, USA 08855
| | - James G. Masters
- Colgate Palmolive Co., Early Research Oral Care, New Jersey, 909
River Road, Piscataway, New Jersey, USA 08855
| | - David T. W. Wong
- Center for Oral/Head & Neck Oncology Research, UCLA School
of Dentistry, University of California at Los Angeles, California, USA
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19
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Trombelli L, Farina R, Silva CO, Tatakis DN. Plaque-induced gingivitis: Case definition and diagnostic considerations. J Clin Periodontol 2018; 45 Suppl 20:S44-S67. [DOI: 10.1111/jcpe.12939] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/15/2017] [Accepted: 10/21/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
- Operative Unit of Dentistry; University-Hospital of Ferrara; Ferrara Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
- Operative Unit of Dentistry; University-Hospital of Ferrara; Ferrara Italy
| | | | - Dimitris N. Tatakis
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
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20
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Munro S, Haile-Mariam A, Greenwell C, Demirci S, Farooqi O, Vasudeva S. Implementation and Dissemination of a Department of Veterans Affairs Oral Care Initiative to Prevent Hospital-Acquired Pneumonia Among Nonventilated Patients. Nurs Adm Q 2018; 42:363-372. [PMID: 30180083 DOI: 10.1097/naq.0000000000000308] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Implementation and dissemination of an oral care initiative enhanced the safety and well-being of Veterans at the Salem VA Medical Center by reducing the risk of non-ventilator-associated hospital-acquired pneumonia (NV-HAP). The incidence rate of non-ventilator-associated hospital-acquired pneumonia decreased from 105 cases to 8.3 cases per 1000 patient-days (by 92%) in the initial VA pilot, yielding an estimated cost avoidance of $2.84 million and 13 lives saved in 19 months postimplementation. The team was successful in translating this research into a meaningful quality improvement intervention in 8 VA hospitals (in North Carolina, Texas, and Virginia) that has promoted effective and consistent delivery of oral care across hospital service lines and systems, improved the health of Veterans, and driven down health care costs associated with this largely preventable illness. The steps needed for successful replication and dissemination of this nurse-led, evidence-based practice are summarized in this article.
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Affiliation(s)
- Shannon Munro
- Department of Veterans Affairs Medical Center, Salem, Virginia (Drs Munro, Farooqi, and Vasudeva), Atlas Research, Contractor Support for the Department of Veterans Affairs Diffusion of Excellence Initiative, Washington, District of Columbia (Mss Haile-Mariam, Greenwell, and Demirci); and Prometheus Federal Services, Contractor Support for the Department of Veterans Affairs Diffusion of Excellence Initiative, Chantilly, Virginia (Ms Demirci)
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21
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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.
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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
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22
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Kong Q, Jin Y, Yan S, Wang Y, Zhao J, Feng Z, Wei J, Wang Y, Kong L, Guo L, Yang J. Examining the association of MMP-1 gene -1607 (2G/1G) and -519 (A/G) polymorphisms with the risk of osteomyelitis: A case-control study. Medicine (Baltimore) 2017; 96:e4969. [PMID: 29049163 PMCID: PMC5662329 DOI: 10.1097/md.0000000000004969] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
To investigate the effects of matrix metalloproteinase-1 (MMP-1) gene polymorphisms on the onset of osteomyelitis in Chinese Han population.In all, 80 osteomyelitis patients (case group) and 81 healthy people (control group) were recruited into this case-control study. Polymerase chain reaction-restriction fragment length polymorphism method was utilized to examine the genotypes of MMP-1 polymorphisms (-1607 2G/1G and -519A/G) in the 2 groups. Genotype and allele differences between the case and control groups were analyzed by chi-square test. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated to present the association strength between MMP-1 gene polymorphisms and osteomyelitis.Frequencies of -1607 2G/2G genotype between the case and control groups were statistically significant (P = .025). Compared with 1G/1G genotype carriers, the 2G/2G genotype carriers had 1.605 times risk of developing osteomyelitis (OR 2.605, 95% CI 1.116-6.082). Meanwhile, the 2G allele significantly associated with the risk of osteomyelitis (OR 1.735, 95% CI 1.115-2.701). In addition, frequency of -519GG genotype was obviously higher in case group than that in control group (P = .024), and GG genotype related to an increased risk of osteomyelitis (OR 2.792, 95% CI 1.127-6.917). Whereas, the -519G allele may be a susceptible factor for osteomyelitis (OR 1.622, 95% CI 1.038-2.536).The MMP-1 -1607 (2G/1G) and -519 (A/G) polymorphisms may contribute to the onset of osteomyelitis.
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Affiliation(s)
- Qingzhu Kong
- Trauma 2 Ward, Southern District of Affiliated Hospital of Chengde Medical College
| | - Yu Jin
- Trauma 2 Ward, Southern District of Affiliated Hospital of Chengde Medical College
| | - Shi Yan
- Trauma 2 Ward, Southern District of Affiliated Hospital of Chengde Medical College
| | - Yin Wang
- Trauma 2 Ward, Southern District of Affiliated Hospital of Chengde Medical College
| | - Jingxin Zhao
- Trauma 2 Ward, Southern District of Affiliated Hospital of Chengde Medical College
| | - Zhen Feng
- Trauma 2 Ward, Southern District of Affiliated Hospital of Chengde Medical College
| | - Junqiang Wei
- Trauma 2 Ward, Southern District of Affiliated Hospital of Chengde Medical College
| | - Yu Wang
- Trauma 2 Ward, Southern District of Affiliated Hospital of Chengde Medical College
| | - Lingwei Kong
- Trauma 2 Ward, Southern District of Affiliated Hospital of Chengde Medical College
| | - Litao Guo
- Department of Ophthalmology, Affiliated Hospital of Chengde Medical College
| | - Jianing Yang
- Second Spine Surgery, Southern District of Affiliated Hospital of Chengde Medical College, Chengde, Hebei, China
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23
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Kornman KS, Giannobile WV, Duff GW. Quo vadis: what is the future of periodontics? How will we get there? Periodontol 2000 2017; 75:353-371. [DOI: 10.1111/prd.12217] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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24
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Zhang Y, Sun J, Lin CC, Abemayor E, Wang MB, Wong DTW. The emerging landscape of salivary diagnostics. Periodontol 2000 2017; 70:38-52. [PMID: 26662481 DOI: 10.1111/prd.12099] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 12/14/2022]
Abstract
Saliva contains a variety of biomolecules, including DNA, coding and noncoding RNA, proteins, metabolites and microbiota. The changes in the salivary levels of these molecular constituents can be used to develop markers for disease detection and risk assessment. Use of saliva as an early-detection tool is a promising approach because collection of saliva is easy and noninvasive. Here, we review recent developments in salivary diagnostics, accomplished using salivaomics approaches, including genomic, transcriptomic, proteomic, metabolomic and microbiomic technologies. Additionally, we illustrate the mechanisms of how diseases distal from the oral cavity can lead to the appearance of discriminatory biomarkers in saliva, and discuss the relevance of these markers for translational and clinical applications.
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25
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Bostanci N, Bao K. Contribution of proteomics to our understanding of periodontal inflammation. Proteomics 2017; 17. [DOI: 10.1002/pmic.201500518] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 11/15/2016] [Accepted: 12/15/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Nagihan Bostanci
- Department of Dental Medicine; Karolinska Institute; Huddinge Sweden
| | - Kai Bao
- Division of Oral Microbiology and Immunology; Institute of Oral Biology; Center of Dental Medicine; University of Zürich; Zürich Switzerland
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26
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Pancer BA, Kott D, Sugai JV, Panagakos FS, Braun TM, Teles RP, Giannobile WV, Kinney JS. Effects of triclosan on host response and microbial biomarkers during experimental gingivitis. J Clin Periodontol 2016; 43:435-44. [PMID: 26820239 DOI: 10.1111/jcpe.12519] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2016] [Indexed: 11/28/2022]
Abstract
AIM This exploratory randomized, controlled clinical trial sought to evaluate anti-inflammatory and -microbial effects of triclosan during experimental gingivitis as assessed by host response biomarkers and biofilm microbial pathogens. MATERIALS AND METHODS Thirty participants were randomized to triclosan or control dentifrice groups who ceased homecare for 21 days in an experimental gingivitis (EG) protocol. Plaque and gingival indices and saliva, plaque, and gingival crevicular fluid (GCF) were assessed/collected at days 0, 14, 21 and 35. Levels and proportions of 40 bacterial species from plaque samples were determined using checkerboard DNA-DNA hybridization. Ten biomarkers associated with inflammation, matrix degradation, and host protection were measured from GCF and saliva and analysed using a multiplex array. Participants were stratified as "high" or "low" responders based on gingival index and GCF biomarkers and bacterial biofilm were combined to generate receiver operating characteristic curves and predict gingivitis susceptibility. RESULTS No differences in mean PI and GI values were observed between groups and non-significant trends of reduction of host response biomarkers with triclosan treatment. Triclosan significantly reduced levels of A. actinomycetemcomitans and P. gingivalis during induction of gingivitis. CONCLUSIONS Triclosan reduced microbial levels during gingivitis development (ClinicalTrials.gov NCT01799226).
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Affiliation(s)
- Brooke A Pancer
- Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan, Ann Arbor, MI, USA
| | - Diana Kott
- Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan, Ann Arbor, MI, USA
| | - James V Sugai
- Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan, Ann Arbor, MI, USA
| | | | - Thomas M Braun
- Biostatistics Department, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Ricardo P Teles
- Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.,Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, USA
| | - William V Giannobile
- Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan, Ann Arbor, MI, USA
| | - Janet S Kinney
- Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan, Ann Arbor, MI, USA
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Zeidán-Chuliá F, Gürsoy M, Neves de Oliveira BH, Özdemir V, Könönen E, Gürsoy UK. A Systems Biology Approach to Reveal Putative Host-Derived Biomarkers of Periodontitis by Network Topology Characterization of MMP-REDOX/NO and Apoptosis Integrated Pathways. Front Cell Infect Microbiol 2016; 5:102. [PMID: 26793622 PMCID: PMC4707239 DOI: 10.3389/fcimb.2015.00102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 12/15/2015] [Indexed: 01/27/2023] Open
Abstract
Periodontitis, a formidable global health burden, is a common chronic disease that destroys tooth-supporting tissues. Biomarkers of the early phase of this progressive disease are of utmost importance for global health. In this context, saliva represents a non-invasive biosample. By using systems biology tools, we aimed to (1) identify an integrated interactome between matrix metalloproteinase (MMP)-REDOX/nitric oxide (NO) and apoptosis upstream pathways of periodontal inflammation, and (2) characterize the attendant topological network properties to uncover putative biomarkers to be tested in saliva from patients with periodontitis. Hence, we first generated a protein-protein network model of interactions ("BIOMARK" interactome) by using the STRING 10 database, a search tool for the retrieval of interacting genes/proteins, with "Experiments" and "Databases" as input options and a confidence score of 0.400. Second, we determined the centrality values (closeness, stress, degree or connectivity, and betweenness) for the "BIOMARK" members by using the Cytoscape software. We found Ubiquitin C (UBC), Jun proto-oncogene (JUN), and matrix metalloproteinase-14 (MMP14) as the most central hub- and non-hub-bottlenecks among the 211 genes/proteins of the whole interactome. We conclude that UBC, JUN, and MMP14 are likely an optimal candidate group of host-derived biomarkers, in combination with oral pathogenic bacteria-derived proteins, for detecting periodontitis at its early phase by using salivary samples from patients. These findings therefore have broader relevance for systems medicine in global health as well.
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Affiliation(s)
- Fares Zeidán-Chuliá
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do SulPorto Alegre, Brazil; Department of Periodontology, Institute of Dentistry, University of TurkuTurku, Finland
| | - Mervi Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku Turku, Finland
| | - Ben-Hur Neves de Oliveira
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil
| | - Vural Özdemir
- Faculty of Communications and Office of the President, International Technology and Innovation Policy, Gaziantep UniversityGaziantep, Turkey; Amrita School of Biotechnology, Amrita Vishwa Vidyapeetham (Amrita University)Kollam, India
| | - Eija Könönen
- Department of Periodontology, Institute of Dentistry, University of TurkuTurku, Finland; Oral Health Care, Welfare DivisionTurku, Finland
| | - Ulvi K Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku Turku, Finland
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Morelli T, Stella M, Barros SP, Marchesan JT, Moss KL, Kim SJ, Yu N, Aspiras MB, Ward M, Offenbacher S. Salivary biomarkers in a biofilm overgrowth model. J Periodontol 2015; 85:1770-8. [PMID: 25079398 DOI: 10.1902/jop.2014.140180] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The purpose of this study is to determine whether baseline salivary inflammatory biomarkers could discriminate between different clinical levels of disease and/or detect clinical changes over a 3-week stent-induced biofilm overgrowth (SIBO) period. METHODS A total of 168 participants were enrolled in a 21-day experimental gingivitis investigation and grouped according to clinical measures of periodontal status of health and diseased individuals representing each of five biofilm gingival interface (BGI) periodontal groups: 1) health, all probing depth (PD) <3 mm and bleeding on probing (BOP) <10%; 2) gingivitis, all PD <3 mm and BOP ≥10%; 3) periodontitis (P)1, ≥1 site with PD >3 mm and BOP ≤10%; 4) P2, ≥1 site with PD >3 mm and BOP >10% but ≤50%; and 5) P3, ≥1 site with PD >3 mm and BOP >50%. Stents were used to prevent plaque removal during brushing over one maxillary and one mandibular posterior dental sextant for 21 days. Clinical periodontal parameters and unstimulated saliva were collected at screening, baseline, and each week during SIBO. Saliva samples were assessed for levels of 13 different biomarkers by multiplex immunoassay. RESULTS Higher salivary levels of interleukin (IL)-1β, matrix metalloproteinase (MMP)-3, MMP-8, MMP-9, and neutrophil gelatinase-associated lipocalin (NGAL) were found in diseased groups compared with the healthy group at baseline. Conversely, higher IL-1 receptor antagonist (ra) levels were found in healthy patients at baseline. In addition, during SIBO, MMP-1, tissue inhibitor of metalloproteinase (TIMP)-1, and TIMP-2 levels increased across all participant groups. A stepwise linear regression model using all salivary biomarkers demonstrated that, at baseline, increased IL-1ra (P = 0.004) and IL-6 (P = 0.009) were significantly associated with change in PDs during SIBO. CONCLUSIONS In summary, this investigation supports salivary levels of IL-1ra and IL-6 as potential indicators for PD changes during induced gingival inflammation. In addition, participants from the BGI-P3 group (severe periodontitis) demonstrated elevated baseline levels of IL-1β, MMP-3, MMP-8, MMP-9, and NGAL compared with the other study groups, strengthening the relevance of participants' biologic phenotype on expression of salivary biomarkers.
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Affiliation(s)
- Thiago Morelli
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Acharya A, Koh ML, Kheur S, Watt RM, Jin L, Mattheos N. Salivary IL-1β and red complex bacteria as predictors of the inflammatory status in sub-peri-implant niches of subjects with peri-implant mucositis. Clin Oral Implants Res 2015; 27:662-7. [PMID: 26456524 DOI: 10.1111/clr.12713] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Salivary biomarkers may enhance diagnostic sensitivity for peri-implant disease assessment. This study aimed to investigate the association of salivary periodontopathogen count and salivary interleukin-1beta (IL-1β) level with the peri-implant crevicular fluid IL-1β response at peri-implant mucositis (PM) sites among subjects with differing periodontal disease susceptibility. MATERIALS AND METHODS Eighty-seven partially edentulous subjects having at least one implant with peri-implant mucositis were included: 40 with history of chronic periodontitis (P) and 47 with no history of periodontitis (NP). Salivary IL-1β, peri-implant crevicular fluid (PICF) IL-1β, and salivary red complex pathogen counts were recorded. Subjects were scored according to a threshold salivary pathogen level of more than 5log (10) counts and assigned a "red complex score." Quartiles of salivary and PICF IL-1β levels were also scored. Area under receiver operating curve (AUC) was computed to predict the highest PICF IL-1β score using salivary biomarker as predictors and age-adjusted logistic regression performed for the significant predictors. RESULTS In the NP group, red complex score (AUC = 0.758 P = 0.010) (odds ratio = 1.377) and salivary IL-1β (AUC = 0.708 P = 0.038) (odds ratio = 2.506) were significant predictors of highest PICF IL-1β quartile score. In the P group, no significant associations were noted. CONCLUSIONS Salivary biomarkers could distinguish the "high" pro-inflammatory responders at PM sites only in subjects without inherent periodontal disease susceptibility. Periodontal susceptibility may impact the immuno-inflammatory response in sub-peri-implant niches of those with peri-implant mucositis.
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Affiliation(s)
- Aneesha Acharya
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China.,Dr D Y Patil Dental College and Hospital, Pimpri, Pune, India
| | - Mei Leng Koh
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China
| | - Supriya Kheur
- Dr D Y Patil Dental College and Hospital, Pimpri, Pune, India
| | - Rory M Watt
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China
| | - Lijian Jin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China
| | - Nikos Mattheos
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China
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Nagarajan R, Miller CS, Dawson D, Al-Sabbagh M, Ebersole JL. Patient-Specific Variations in Biomarkers across Gingivitis and Periodontitis. PLoS One 2015; 10:e0136792. [PMID: 26407063 PMCID: PMC4583448 DOI: 10.1371/journal.pone.0136792] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/08/2015] [Indexed: 12/31/2022] Open
Abstract
This study investigates the use of saliva, as an emerging diagnostic fluid in conjunction with classification techniques to discern biological heterogeneity in clinically labelled gingivitis and periodontitis subjects (80 subjects; 40/group) A battery of classification techniques were investigated as traditional single classifier systems as well as within a novel selective voting ensemble classification approach (SVA) framework. Unlike traditional single classifiers, SVA is shown to reveal patient-specific variations within disease groups, which may be important for identifying proclivity to disease progression or disease stability. Salivary expression profiles of IL-1ß, IL-6, MMP-8, and MIP-1α from 80 patients were analyzed using four classification algorithms (LDA: Linear Discriminant Analysis [LDA], Quadratic Discriminant Analysis [QDA], Naïve Bayes Classifier [NBC] and Support Vector Machines [SVM]) as traditional single classifiers and within the SVA framework (SVA-LDA, SVA-QDA, SVA-NB and SVA-SVM). Our findings demonstrate that performance measures (sensitivity, specificity and accuracy) of traditional classification as single classifier were comparable to that of the SVA counterparts using clinical labels of the samples as ground truth. However, unlike traditional single classifier approaches, the normalized ensemble vote-counts from SVA revealed varying proclivity of the subjects for each of the disease groups. More importantly, the SVA identified a subset of gingivitis and periodontitis samples that demonstrated a biological proclivity commensurate with the other clinical group. This subset was confirmed across SVA-LDA, SVA-QDA, SVA-NB and SVA-SVM. Heatmap visualization of their ensemble sets revealed lack of consensus between these subsets and the rest of the samples within the respective disease groups indicating the unique nature of the patients in these subsets. While the source of variation is not known, the results presented clearly elucidate the need for novel approaches that accommodate inherent heterogeneity and personalized variations within disease groups in diagnostic characterization. The proposed approach falls within the scope of P4 medicine (predictive, preventive, personalized, and participatory) with the ability to identify unique patient profiles that may predict specific disease trajectories and targeted disease management.
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Affiliation(s)
- Radhakrishnan Nagarajan
- Division of Biomedical Informatics, Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, United States of America
| | - Craig S. Miller
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, United States of America
- Division of Oral Medicine, Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, KY, United States of America
| | - Dolph Dawson
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, United States of America
- Division of Periodontics, Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, KY, United States of America
| | - Mohanad Al-Sabbagh
- Division of Periodontics, Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, KY, United States of America
| | - Jeffrey L. Ebersole
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, United States of America
- * E-mail:
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31
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Ebersole JL, Nagarajan R, Akers D, Miller CS. Targeted salivary biomarkers for discrimination of periodontal health and disease(s). Front Cell Infect Microbiol 2015; 5:62. [PMID: 26347856 PMCID: PMC4541326 DOI: 10.3389/fcimb.2015.00062] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/03/2015] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Generally, clinical parameters are used in dental practice for periodontal disease, yet several drawbacks exist with the clinical standards for addressing the needs of the public at large in determining the current status/progression of the disease, and requiring a significant amount of damage before these parameters can document disease. Therefore, a quick, easy and reliable method of assessing and monitoring periodontal disease should provide important diagnostic information that improves and speeds treatment decisions and moves the field closer to individualized point-of-care diagnostics. OBJECTIVE This report provides results for a saliva-based diagnostic approach for periodontal health and disease based upon the abundance of salivary analytes coincident with disease, and the significant progress already made in the identification of discriminatory salivary biomarkers of periodontitis. METHODS We evaluated biomarkers representing various phases of periodontitis initiation and progression (IL-1ß, IL-6, MMP-8, MIP-1α) in whole saliva from 209 subjects categorized with periodontal health, gingivitis, and periodontitis. RESULTS Evaluation of the salivary analytes demonstrated utility for individual biomarkers to differentiate periodontitis from health. Inclusion of gingivitis patients into the analyses provided a more robust basis to estimate the value of each of these analytes. Various clinical and statistical approaches showed that pairs or panels of the analytes were able to increase the sensitivity and specificity for the identification of disease. CONCLUSIONS Salivary concentrations of IL-1ß, IL-6, MMP-8, MIP-1α alone and in combination are able to distinguish health from gingivitis and periodontitis. The data clearly demonstrated a heterogeneity in response profiles of these analytes that supports the need for refinement of the standard clinical classifications if we are to move toward precision/personalized dentistry for the twenty-first century.
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Affiliation(s)
- Jeffrey L Ebersole
- Center for Oral Health Research, College of Dentistry, University of Kentucky Lexington, KY, USA
| | - Radhakrishnan Nagarajan
- Division of Biomedical Informatics, College of Public Health, University of Kentucky Lexington, KY, USA
| | - David Akers
- Department of Statistics, College of Arts and Sciences, University of Kentucky Lexington, KY, USA
| | - Craig S Miller
- Center for Oral Health Research, College of Dentistry, University of Kentucky Lexington, KY, USA ; Division of Oral Diagnosis, Oral Medicine and Oral Radiology, College of Dentistry, University of Kentucky Lexington, KY, USA
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32
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Leppilahti JM, Sorsa T, Kallio MA, Tervahartiala T, Emingil G, Han B, Mäntylä P. The Utility of Gingival Crevicular Fluid Matrix Metalloproteinase-8 Response Patterns in Prediction of Site-Level Clinical Treatment Outcome. J Periodontol 2015; 86:777-87. [DOI: 10.1902/jop.2015.140421] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Aruni AW, Dou Y, Mishra A, Fletcher HM. The Biofilm Community-Rebels with a Cause. CURRENT ORAL HEALTH REPORTS 2015; 2:48-56. [PMID: 26120510 PMCID: PMC4478205 DOI: 10.1007/s40496-014-0044-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Oral Biofilms are one of the most complex and diverse ecosystem developed by successive colonization of more than 600 bacterial taxa. Development starts with the attachment of early colonizers such as Actinomyces species and oral streptococci on the acquired pellicle and tooth enamel. These bacteria not only adhere to tooth surface but also interact with each other and lay foundation for attachment of bridging colonizer such as Fusobacterium nucleatum followed by late colonizers including the red complex species: Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola-the founders of periodontal disease. As the biofilm progresses from supragingival sites to subgingival sites, the environment changes from aerobic to anaerobic thus favoring the growth of mainly Gram-negative obligate anaerobes while restricting the growth of the early Gram-positive facultative aerobes. Microbes present at supragingival level are mainly related to gingivitis and root-caries whereas subgingival species advance the destruction of teeth supporting tissues and thus causing periodontitis. This review summarizes our present understanding and recent developments on the characteristic features of supra- and subgingival biofilms, interaction between different genera and species of bacteria constituting these biofilms and draws our attention to the role of some of the recently discovered members of the oral community.
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Affiliation(s)
- A. Wilson Aruni
- Division of Microbiology and Molecular Genetics, School of Medicine, Loma Linda University, Loma Linda, CA-92354
| | - Yuetan Dou
- Division of Microbiology and Molecular Genetics, School of Medicine, Loma Linda University, Loma Linda, CA-92354
| | - Arunima Mishra
- Division of Microbiology and Molecular Genetics, School of Medicine, Loma Linda University, Loma Linda, CA-92354
| | - Hansel M. Fletcher
- Division of Microbiology and Molecular Genetics, School of Medicine, Loma Linda University, Loma Linda, CA-92354
- Institute of Oral Biology, Kyung Hee University, Seoul, Republic of Korea
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Cogulu D, Onay H, Ozdemir Y, I. Aslan G, Ozkinay F, Kutukculer N, Eronat C. Associations of interleukin (IL)-1β, IL-1 receptor antagonist, and IL-10 with dental caries. J Oral Sci 2015; 57:31-6. [DOI: 10.2334/josnusd.57.31] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Dilsah Cogulu
- Department of Pedodontics, School of Dentistry, Ege University
| | - Huseyin Onay
- Department of Medical Genetics, School of Medicine, Ege University
| | | | - Gulcin I. Aslan
- Department of Medical Biology, School of Medicine, Izmir University
| | - Ferda Ozkinay
- Department of Medical Genetics, School of Medicine, Ege University
| | - Necil Kutukculer
- Department of Pediatric Immunology, School of Medicine, Ege University
| | - Cemal Eronat
- Department of Pedodontics, School of Dentistry, Ege University
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35
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Kosaka T, Kokubo Y, Ono T, Sekine S, Kida M, Kikui M, Yamamoto M, Watanabe M, Amano A, Maeda Y, Miyamoto Y. Salivary inflammatory cytokines may be novel markers of carotid atherosclerosis in a Japanese general population: the Suita study. Atherosclerosis 2014; 237:123-8. [PMID: 25238219 DOI: 10.1016/j.atherosclerosis.2014.08.046] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 08/22/2014] [Accepted: 08/29/2014] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Salivary biomarkers have been recently useful of periodontal disease, which is also risk factor of atherosclerosis. However, there are few studies of the association between salivary inflammatory cytokines and carotid atherosclerosis. We aimed to clarify the association between salivary inflammatory cytokines and periodontal disease and carotid atherosclerosis in a general urban population. METHODS We studied 608 Japanese men and women (mean age: 65.4 years) in the Suita study. Carotid atherosclerosis was evaluated by high-resolution ultrasonography with atherosclerotic indexes of intima-media thickness (IMT). Periodontal status was evaluated by the Community Periodontal Index (CPI). Salivary levels of interleukin-1β, interleukin-6, tumor necrosis factor-α (TNF-α), and prostaglandin E2 (PGE2) were measured by enzyme linked immunosorbent assay. The risks of carotid atherosclerosis (≥75th percentiles of mean- [0.88 mm] and Max-IMT [1.50 mm]) according to the quartiles of salivary inflammatory cytokines were compared using of adjusted-logistic regression models. RESULTS AND CONCLUSION All salivary inflammatory cytokines were positively associated with CPI. The adjusted odds ratios for carotid atherosclerosis of mean-IMT in the highest quartile of interleukin-6 and TNF-α were higher than those in the lowest quartiles (OR = 2.32 and 2.88; 95% confidence intervals = 1.19-4.51 and 1.51-5.49, respectively). The adjusted odds ratio for carotid atherosclerosis of mean-IMT in the highest quartile of PGE2 was greater than those in the lowest quartile in women (OR = 2.78; 95% confidence intervals = 1.11-6.95). In conclusion, higher levels of salivary inflammatory cytokines were associated with both periodontal disease and carotid atherosclerosis. Selected salivary inflammatory cytokines may be useful screening markers for periodontal disease and carotid atherosclerosis.
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Affiliation(s)
- Takayuki Kosaka
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.
| | - Takahiro Ono
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Shinichi Sekine
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Momoyo Kida
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Miki Kikui
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Masaaki Yamamoto
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Makoto Watanabe
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.
| | - Atsuo Amano
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Yoshihiro Miyamoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.
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Fernandez y Mostajo M, van der Reijden WA, Buijs MJ, Beertsen W, Van der Weijden F, Crielaard W, Zaura E. Effect of an oxygenating agent on oral bacteria in vitro and on dental plaque composition in healthy young adults. Front Cell Infect Microbiol 2014; 4:95. [PMID: 25101249 PMCID: PMC4107829 DOI: 10.3389/fcimb.2014.00095] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 06/23/2014] [Indexed: 11/25/2022] Open
Abstract
Oral bacteria live in symbiosis with the host. Therefore, when mouthwashes are indicated, selective inhibition of taxa contributing to disease is preferred instead of broad-spectrum antimicrobials. The potential selectivity of an oxygenating mouthwash, Ardox-X® (AX), has not been assessed. The aim of this study was to determine the antimicrobial potential of AX and the effects of a twice-daily oral rinse on dental plaque composition. Material and methods:In vitro, 16 oral bacterial strains were tested using agar diffusion susceptibility, minimum inhibitory and minimum bactericidal concentration tests. A pilot clinical study was performed with 25 healthy volunteers. Clinical assessments and microbiological sampling of supragingival plaque were performed at 1 month before the experiment (Pre-exp), at the start of the experiment (Baseline) and after the one-week experimental period (Post-exp). During the experiment individuals used AX mouthwash twice daily in absence of other oral hygiene measures. The microbiological composition of plaque was assessed by 16S rRNA gene amplicon sequencing. Results: AX showed high inter-species variation in microbial growth inhibition. The tested Prevotella strains and Fusobacterium nucleatum showed the highest sensitivity, while streptococci and Lactobacillus acidophilus were most resistant to AX. Plaque scores at Pre-exp and Baseline visits did not differ significantly (p = 0.193), nor did the microbial composition of plaque. During a period of 7-days non-brushing but twice daily rinsing plaque scores increased from 2.21 (0.31) at Baseline to 2.43 (0.39) Post-exp. A significant microbial shift in composition was observed: genus Streptococcus and Veillonella increased while Corynebacterium, Haemophilus, Leptotrichia, Cardiobacterium and Capnocytophaga decreased (p ≤ 0.001). Conclusion: AX has the potential for selective inhibition of oral bacteria. The shift in oral microbiome after 1 week of rinsing deserves further research.
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Affiliation(s)
- Mercedes Fernandez y Mostajo
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam Amsterdam, Netherlands
| | - Wil A van der Reijden
- Regional Laboratory for Public Health Haarlem, Department Molecular Biology Haarlem, Netherlands
| | - Mark J Buijs
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam Amsterdam, Netherlands
| | - Wouter Beertsen
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam Amsterdam, Netherlands
| | - Fridus Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam Amsterdam, Netherlands
| | - Wim Crielaard
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam Amsterdam, Netherlands
| | - Egija Zaura
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam Amsterdam, Netherlands
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Rocha FS, Jesus RNR, Rocha FMS, Moura CCG, Zanetta-Barbosa D. Saliva versus peri-implant inflammation: quantification of IL-1β in partially and totally edentulous patients. J ORAL IMPLANTOL 2014; 40:169-73. [PMID: 24779950 DOI: 10.1563/aaid-joi-d-11-00224] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to investigate the potential use of salivary IL1β in early-stage diagnostics of peri-implant inflammation in partially and totally edentulous patients rehabilitated with dental implants. Patients were classified according to peri-implant probing depth and bleeding upon probing in groups of healthy individuals or in groups of individuals with peri-implant inflammation. Data on plaque index, clinical attachment loss, suppuration, and mobility were also assessed. Saliva was collected without stimulation, and the levels of IL-1β were determined by ELISA. Healthy groups demonstrated significantly lower levels of IL-1β compared with the inflammation groups. No difference in IL-1β levels was observed between partially edentulous or totally edentulous patients. Salivary IL-1β may be useful for the diagnosis and monitoring of early peri-implant inflammation, particularly in edentulous patients.
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Affiliation(s)
- Flaviana Soares Rocha
- 1 School of Dentistry, Universidade Federal Uberlândia, Uberlândia, Minas Gerais, Brazil
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Teles R, Teles F, Frias-Lopez J, Paster B, Haffajee A. Lessons learned and unlearned in periodontal microbiology. Periodontol 2000 2014; 62:95-162. [PMID: 23574465 PMCID: PMC3912758 DOI: 10.1111/prd.12010] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Periodontal diseases are initiated by bacterial species living in polymicrobial biofilms at or below the gingival margin and progress largely as a result of the inflammation elicited by specific subgingival species. In the past few decades, efforts to understand the periodontal microbiota have led to an exponential increase in information about biofilms associated with periodontal health and disease. In fact, the oral microbiota is one of the best-characterized microbiomes that colonize the human body. Despite this increased knowledge, one has to ask if our fundamental concepts of the etiology and pathogenesis of periodontal diseases have really changed. In this article we will review how our comprehension of the structure and function of the subgingival microbiota has evolved over the years in search of lessons learned and unlearned in periodontal microbiology. More specifically, this review focuses on: (i) how the data obtained through molecular techniques have impacted our knowledge of the etiology of periodontal infections; (ii) the potential role of viruses in the etiopathogenesis of periodontal diseases; (iii) how concepts of microbial ecology have expanded our understanding of host-microbe interactions that might lead to periodontal diseases; (iv) the role of inflammation in the pathogenesis of periodontal diseases; and (v) the impact of these evolving concepts on therapeutic and preventive strategies to periodontal infections. We will conclude by reviewing how novel systems-biology approaches promise to unravel new details of the pathogenesis of periodontal diseases and hopefully lead to a better understanding of their mechanisms.
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Predictive modeling of gingivitis severity and susceptibility via oral microbiota. ISME JOURNAL 2014; 8:1768-80. [PMID: 24646694 DOI: 10.1038/ismej.2014.32] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 12/17/2013] [Accepted: 01/29/2014] [Indexed: 01/17/2023]
Abstract
Predictive modeling of human disease based on the microbiota holds great potential yet remains challenging. Here, 50 adults underwent controlled transitions from naturally occurring gingivitis, to healthy gingivae (baseline), and to experimental gingivitis (EG). In diseased plaque microbiota, 27 bacterial genera changed in relative abundance and functional genes including 33 flagellar biosynthesis-related groups were enriched. Plaque microbiota structure exhibited a continuous gradient along the first principal component, reflecting transition from healthy to diseased states, which correlated with Mazza Gingival Index. We identified two host types with distinct gingivitis sensitivity. Our proposed microbial indices of gingivitis classified host types with 74% reliability, and, when tested on another 41-member cohort, distinguished healthy from diseased individuals with 95% accuracy. Furthermore, the state of the microbiota in naturally occurring gingivitis predicted the microbiota state and severity of subsequent EG (but not the state of the microbiota during the healthy baseline period). Because the effect of disease is greater than interpersonal variation in plaque, in contrast to the gut, plaque microbiota may provide advantages in predictive modeling of oral diseases.
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Syndergaard B, Al-Sabbagh M, Kryscio RJ, Xi J, Ding X, Ebersole JL, Miller CS. Salivary biomarkers associated with gingivitis and response to therapy. J Periodontol 2014; 85:e295-303. [PMID: 24502627 DOI: 10.1902/jop.2014.130696] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Salivary biomarkers are potentially important for determining the presence, risk, and progression of periodontal disease. However, clinical translation of biomarker technology from lab to chairside requires studies that identify biomarkers associated with the transitional phase between health and periodontal disease (i.e., gingivitis). METHODS Eighty participants (40 with gingivitis, 40 healthy) provided saliva at baseline and 7 to 30 days later. An additional sample was collected from gingivitis participants 10 to 30 days after dental prophylaxis. Clinical parameters of gingival disease were recorded at baseline and the final visit. Salivary concentrations of interleukin (IL)-1β, IL-6, matrix metalloproteinase (MMP)-8, macrophage inflammatory protein (MIP)-1α, and prostaglandin E2 (PGE2) were measured. RESULTS Clinical features of health and gingivitis were stable at both baseline visits. Participants with gingivitis demonstrated significantly higher bleeding on probing (BOP), plaque index (PI), and gingival index (GI) (P ≤0.002) and a significant drop in BOP, PI, and GI post-treatment (P ≤0.001). Concentrations of MIP-1α and PGE2 were significantly higher (2.8 times) in the gingivitis group than the healthy group (P ≤0.02). After dental prophylaxis, mean biomarker concentrations did not decrease significantly from baseline in the gingivitis group, although concentrations of IL-1β, IL-6, and MMP-8 approached healthy levels, whereas MIP-1α and PGE2 concentrations remained significantly higher than in the healthy group (P ≤0.04). Odds ratio analyses showed that PGE2 concentrations, alone and in combination with MIP-1α, readily discriminated gingivitis from health. CONCLUSIONS Salivary PGE2 and MIP-1α discriminate gingivitis from health, and patients with gingivitis who return to clinical health continue to produce inflammatory mediators for weeks after dental prophylaxis.
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Affiliation(s)
- Ben Syndergaard
- Department of Oral Health Practice, Center for Oral Health Research, University of Kentucky, Lexington, KY
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Leppilahti JM, Kallio MA, Tervahartiala T, Sorsa T, Mäntylä P. Gingival Crevicular Fluid Matrix Metalloproteinase-8 Levels Predict Treatment Outcome Among Smokers With Chronic Periodontitis. J Periodontol 2014; 85:250-60. [DOI: 10.1902/jop.2013.130156] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Little FF, Delgado DM, Wexler PJ, Oppenheim FG, Mitchell P, Feldman JA, Walt DR, Peng RD, Matsui EC. Salivary inflammatory mediator profiling and correlation to clinical disease markers in asthma. PLoS One 2014; 9:e84449. [PMID: 24409298 PMCID: PMC3883659 DOI: 10.1371/journal.pone.0084449] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 11/16/2013] [Indexed: 11/19/2022] Open
Abstract
Rationale There is a need for a readily available, non-invasive source of biomarkers that predict poor asthma control. Objectives We sought to determine if there is an association between the salivary inflammatory profile and disease control in children and adults with asthma. Methods In this cross-sectional study, we collected demographic and clinical information from two independent populations at different sites, resulting in convenience samples of 58 pediatric and 122 adult urban asthmatics. Control was assessed by symptom questionnaire (children) and by Asthma Control Questionnaire and current exacerbation (adults). Saliva was collected in all subjects. We applied principal component analysis to a 10-plex panel of relevant inflammatory markers to characterize marker profiles and determined if profiles were associated with asthma control. Results There were similar, strong correlations amongst biologically related markers in both populations: eosinophil-related: eotaxin-1/CCL11, RANTES/CCL5, and IL-5 (p<.001); myeloid/innate: IL-1β, IL-6, MCP-1/CCL2, and IL-8/CXCL8 (p<.001). The first three principal components captured ≥74% of variability across all ten analytes in both populations. In adults, the Principal Component 1 score, broadly reflective of all markers, but with greater weight given to myeloid/innate markers, was associated with Asthma Control Questionnaire score and exacerbation. The Principal Component 3 score, reflective of IP-10/CXCL10, was associated with current exacerbation. In children, the Principal Component 1, 2, and 3 scores were associated with recent asthma symptoms. The Principal Component 2 score, reflective of higher eosinophil markers, was inversely correlated with symptoms. The Principal Component 3 score was positively associated with all symptom outcomes. Conclusion The salivary inflammatory profile is associated with disease control in children and adults with asthma.
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Affiliation(s)
- Frédéric F. Little
- Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
- * E-mail: (FL)
| | - Diana M. Delgado
- Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Philip J. Wexler
- Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Frank G. Oppenheim
- Department of Periodontology and Oral Biology, Boston University Goldman School of Dental Medicine, Boston, Massachusetts, United States of America
| | - Patricia Mitchell
- Department of Emergency Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - James A. Feldman
- Department of Emergency Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - David R. Walt
- Department of Chemistry, Tufts University, Medford, Massachusetts, United States of America
| | - Roger D. Peng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Elizabeth C. Matsui
- Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Belibasakis GN, Öztürk VÖ, Emingil G, Bostanci N. Soluble Triggering Receptor Expressed on Myeloid Cells 1 (sTREM-1) in Gingival Crevicular Fluid: Association With Clinical and Microbiologic Parameters. J Periodontol 2014; 85:204-10. [DOI: 10.1902/jop.2013.130144] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Byrne ML, O'Brien-Simpson NM, Reynolds EC, Walsh KA, Laughton K, Waloszek JM, Woods MJ, Trinder J, Allen NB. Acute phase protein and cytokine levels in serum and saliva: a comparison of detectable levels and correlations in a depressed and healthy adolescent sample. Brain Behav Immun 2013; 34:164-75. [PMID: 23999491 DOI: 10.1016/j.bbi.2013.08.010] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 08/15/2013] [Accepted: 08/23/2013] [Indexed: 12/23/2022] Open
Abstract
Recent research has examined associations between inflammation and mental health, and has increasingly focused on utilising younger samples to characterise the temporal relationship between inflammatory responses and the emergence of other symptoms. These studies have typically used blood to measure inflammation, although rates of detection for many inflammatory markers appear to be low. Saliva is a safe and low-cost alternative, and adult research has shown that levels of some salivary markers correlate well with those in serum. However, no research has examined this association in young people. This study examined 16 inflammatory markers in serum and saliva in 17 depressed adolescents and 18 healthy controls, aged 13-18 years. In general, detection rates were higher in saliva compared to in serum. When non-detectable levels were excluded, serum levels of C-reactive protein (CRP) correlated with salivary CRP (r=0.424, p=0.015), and this correlation appeared to only exist for those individuals with high levels of serum CRP (r=0.599, p=0.014). However, when non-detectable levels were included as zero, salivary levels of CRP, interleukin (IL)-2, IL-12p70, and interferon (IFN)-γ correlated with their serum counterparts. No significant clinical group differences in any acute phase proteins or cytokines were present. This study suggests that saliva can be used to measure inflammation in studies with adolescent participants, especially CRP, as it appears to correlate with systemic inflammation for those individuals who are expected to have high levels of inflammation. Implications for future directions in research on salivary inflammatory markers are discussed.
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Affiliation(s)
- Michelle L Byrne
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia
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Ebersole JL, Dawson DR, Morford LA, Peyyala R, Miller CS, Gonzaléz OA. Periodontal disease immunology: 'double indemnity' in protecting the host. Periodontol 2000 2013; 62:163-202. [PMID: 23574466 PMCID: PMC4131201 DOI: 10.1111/prd.12005] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
During the last two to three decades our understanding of the immunobiology of periodontal disease has increased exponentially, both with respect to the microbial agents triggering the disease process and the molecular mechanisms of the host engagement maintaining homeostasis or leading to collateral tissue damage. These foundational scientific findings have laid the groundwork for translating cell phenotype, receptor engagement, intracellular signaling pathways and effector functions into a 'picture' of the periodontium as the host responds to the 'danger signals' of the microbial ecology to maintain homeostasis or succumb to a disease process. These findings implicate the chronicity of the local response in attempting to manage the microbial challenge, creating a 'Double Indemnity' in some patients that does not 'insure' health for the periodontium. As importantly, in reflecting the title of this volume of Periodontology 2000, this review attempts to inform the community of how the science of periodontal immunology gestated, how continual probing of the biology of the disease has led to an evolution in our knowledge base and how more recent studies in the postgenomic era are revolutionizing our understanding of disease initiation, progression and resolution. Thus, there has been substantial progress in our understanding of the molecular mechanisms of host-bacteria interactions that result in the clinical presentation and outcomes of destructive periodontitis. The science has embarked from observations of variations in responses related to disease expression with a focus for utilization of the responses in diagnosis and therapeutic outcomes, to current investigations using cutting-edge fundamental biological processes to attempt to model the initiation and progression of soft- and hard-tissue destruction of the periodontium. As importantly, the next era in the immunobiology of periodontal disease will need to engage more sophisticated experimental designs for clinical studies to enable robust translation of basic biologic processes that are in action early in the transition from health to disease, those which stimulate microenvironmental changes that select for a more pathogenic microbial ecology and those that represent a rebalancing of the complex host responses and a resolution of inflammatory tissue destruction.
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Martínez-Pabón MC, Duque-Agudelo L, Díaz-Gil JD, Isaza-Guzmán DM, Tobón-Arroyave SI. Comparison of the effect of two sugar-substituted chewing gums on different caries- and gingivitis-related variables: a double-blind, randomized, controlled clinical trial. Clin Oral Investig 2013; 18:589-98. [PMID: 23604701 DOI: 10.1007/s00784-013-0989-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 04/08/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to compare the effect of two sugar-substituted chewing gums besides toothbrushing on different clinical, microbiological, and biochemical caries- and gingivitis-related variables. MATERIALS AND METHODS The study was designed as a double-blind, randomized, controlled trial with three parallel arms. A total of 130 dental students, who volunteered after signing an informed consent, were randomly allocated to receive one of the following interventions: hexitol-sweetened gum containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), pentitol-sweetened gum containing no CPP-ACP, and control group with no gum. Subjects within the experimental groups chewed two gum pellets for 20 min three times a day after meals. The daily consumption level of both polyols was 6.0 g. Clinical examinations and salivary samplings were conducted at baseline and after 30 days of gum use. Pre- and post-intervention stimulated whole saliva samples were quantified for calcium/phosphate ionic concentration, total facultative bacterial load, Streptococcus mutans/Lactobacillus spp. counts, and Gram-negative percentage. RESULTS A statistically significant reduction in visible plaque score was displayed in the hexitol/CPP-ACP gum group after the intervention when compared with baseline, but the order of the effect was in the same order as the differences between the groups at baseline. A similar tendency was seen in both the pentitol/non-CPP-ACP gum and control groups regarding total salivary facultative bacterial load and S. mutans count, but median values of these parameters were more significantly reduced in the pentitol/non-CPP-ACP gum group in comparison with those of the control group. Alterations of salivary Lactobacillus spp. were demonstrated only in the pentitol/non-CPP-ACP gum group. CONCLUSION Although these findings might indicate that a 30-day protocol of daily chewing of pentitol-sweetened gum containing no CPP-ACP might have some a reducing effect on the salivary levels of facultative bacteria, S. mutans and Lactobacillus spp., there was only a marginal, if any, benefit from the chewing gums under study on some microbiological caries- and gingivitis-related variables. CLINICAL RELEVANCE Taking into account that for transferring results into clinically relevant conclusions the findings need to be strong and consistent, adhering to single significant differences appears not appropriate. Hence, the clinical significance of chewing gums as an adjunctive tool for daily oral care remained questionable.
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Affiliation(s)
- María C Martínez-Pabón
- POPCAD Research Group, Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Calle 64 No. 52-59, Medellín, Colombia
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Abstract
BACKGROUND and Overview The use of salivary diagnostics continues to develop and advance the field of risk determination for periodontal diseases. Researchers are investigating genetic, microbial and protein biomarkers with the objective of translating findings to such aspects of clinical care as broad patient screening, monitoring and treatment planning. METHODS /st> In this review, the author briefly explores currently available salivary diagnostics used to identify bacteria prevalent in periodontal disease, and focuses on the future development and use of a variety of rapid disease detection platforms, such as lab-on-a-chip, as a point-of-care device for identification of patients' risk. CONCLUSIONS and CLINICAL IMPLICATIONS /st> Several diagnostic tests are commercially available, and point-of-care tests are under development. However, challenges remain regarding the introduction of these technologies to clinical practice and adoption by dental practitioners for promotion of personalized oral health care.
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Bonne NJ, Wong DT. Salivary biomarker development using genomic, proteomic and metabolomic approaches. Genome Med 2012; 4:82. [PMID: 23114182 PMCID: PMC3580451 DOI: 10.1186/gm383] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The use of saliva as a diagnostic sample provides a non-invasive, cost-efficient method of sample collection for disease screening without the need for highly trained professionals. Saliva collection is far more practical and safe compared with invasive methods of sample collection, because of the infection risk from contaminated needles during, for example, blood sampling. Furthermore, the use of saliva could increase the availability of accurate diagnostics for remote and impoverished regions. However, the development of salivary diagnostics has required technical innovation to allow stabilization and detection of analytes in the complex molecular mixture that is saliva. The recent development of cost-effective room temperature analyte stabilization methods, nucleic acid pre-amplification techniques and direct saliva transcriptomic analysis have allowed accurate detection and quantification of transcripts found in saliva. Novel protein stabilization methods have also facilitated improved proteomic analyses. Although candidate biomarkers have been discovered using epigenetic, transcriptomic, proteomic and metabolomic approaches, transcriptomic analyses have so far achieved the most progress in terms of sensitivity and specificity, and progress towards clinical implementation. Here, we review recent developments in salivary diagnostics that have been accomplished using genomic, transcriptomic, proteomic and metabolomic approaches.
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Affiliation(s)
- Nicolai J Bonne
- School of Dentistry and Dental Research Institute, University of California Los Angeles, 650 Charles Young Drive, CHS 73-032, Los Angeles, California, USA
| | - David Tw Wong
- School of Dentistry and Dental Research Institute, University of California Los Angeles, 650 Charles Young Drive, CHS 73-032, Los Angeles, California, USA
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Chang PC, Chien LY, Ye Y, Kao MJ. Irradiation by light-emitting diode light as an adjunct to facilitate healing of experimental periodontitis in vivo. J Periodontal Res 2012; 48:135-43. [PMID: 22845797 DOI: 10.1111/j.1600-0765.2012.01511.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE This study evaluated the biostimulatory effect of 660 nm light-emitting diode (LED) as an adjunct in the treatment of experimental periodontitis. MATERIAL AND METHODS Ninety-six Sprague-Dawley rats underwent experimental periodontitis by placement of a silk ligature followed with or without additive Porphyromonas gingivalis lipopolysaccharide (Pg-LPS) injection. Irradiation with LED light was performed at varying energy densities of 5, 10 and 15 J/cm2, 1 d after debridement and detoxification. Rats were killed at 3, 7 and 14 d after irradiation with LED light, and the effect of irradiation was evaluated by descriptive histology and quantitative measurements of periodontal bone loss, inflammatory infiltration and cellular proliferation. RESULTS Reduction of inflammation, accelerated collagen deposition and realignment was noted following irradiation with LED light at densities of 10 and 15 J/cm2, and temporary reduction of periodontal bone loss, as well as bundle bone apposition, was noted at day 3 in rats treated with 10 J/cm2 light. The biomodulatory effect was stronger in sites treated with Pg-LPS injection. In sites without Pg-LPS injection, temporary reduction of inflammation was noted in all LED light-irradiated specimens at day 3. No significant change in cellular proliferation was noted in any LED light-treated group. CONCLUSIONS LED light (660 nm) with an energy density of 10 J/cm2 appeared suitable as an adjunct modality for periodontitis by temporarily reducing inflammation, facilitating collagen realignment and bundle bone deposition. Future studies will aim to amplify the biostimulatory effect of LED light by adding a supplementary medium or repeated irradiation.
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Affiliation(s)
- P-C Chang
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore.
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Comparison of biomarkers in blood and saliva in healthy adults. Nurs Res Pract 2012; 2012:246178. [PMID: 22619709 PMCID: PMC3350846 DOI: 10.1155/2012/246178] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Accepted: 03/01/2012] [Indexed: 01/12/2023] Open
Abstract
Researchers measure biomarkers as a reflection of patient health status or intervention outcomes. While blood is generally regarded as the best body fluid for evaluation of systemic processes, substitution of saliva samples for blood would be less invasive and more convenient. The concentration of specific biomarkers may differ between blood and saliva. The objective of this study was to compare multiple biomarkers (27 cytokines) in plasma samples, passive drool saliva samples, and filter paper saliva samples in 50 healthy adults. Demographic data and three samples were obtained from each subject: saliva collected on filter paper over 1 minute, saliva collected by passive drool over 30 seconds, and venous blood (3 mL) collected by venipuncture. Cytokines were assayed using Bio-Rad multiplex suspension array technology. Descriptive statistics and pairwise correlations were used for data analysis. The sample was 52% male and 74% white. Mean age was 26 (range = 19–63 years, sd = 9.7). The most consistent and highest correlations were between the passive drool and filter paper saliva samples, although relationships were dependent on the specific biomarker. Correlations were not robust enough to support substitution of one collection method for another. There was little correlation between the plasma and passive drool saliva samples. Caution should be used in substituting saliva for blood, and relationships differ by biomarker.
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