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Karesvuo M, Sorsa T, Tuuminen R. Association between Oral Active-Matrix Metalloproteinase-8 Levels and Subretinal Fibrosis among Wet Age-Related Macular Degeneration Patients. Curr Eye Res 2024; 49:288-294. [PMID: 37975315 DOI: 10.1080/02713683.2023.2280442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Periodontitis causes low-grade systemic inflammation and has been associated with elevated active-matrix metalloproteinase (aMMP-8) levels, blood-ocular barrier breakdown and a risk of wet age-related macular degeneration. To assess the association between aMMP-8 levels and macular status among patients with wet age-related macular degeneration (AMD). METHODS Patients on anti-VEGF treatment for wet AMD were enrolled for oral aMMP-8 rinse test in Mehiläinen Private Hospital, Helsinki, Finland. Macular status was examined from spectral-domain optical coherence tomography (SD-OCT) scans by a medical retina specialist and aMMP-8 levels were analyzed with chairside point-of-care oral rinse (PerioSafe®) test and real-time quantitated by a dentist using the ORALyzer®- reader with a 10 ng/ml cut-off for aMMP-8 activity. RESULTS Elevated aMMP-8 levels were found in 10 out of 32 patients. Age, gender, anti-VEGF (bevacizumab or aflibercept) distribution, cumulative number of anti-VEGF injections and treatment interval were comparable between patients with aMMP-8 levels below and above the point-of-care level. Macular status differed in regard to aMMP-8 activity; among patients with aMMP-8 levels below the point-of-care subretinal fibrosis was found in 6 out of 22 eyes, whereas among patients with aMMP-8 levels above the point-of-care subretinal fibrosis was found in 8 out of 10 eyes (p = 0.005). Respectively, the mean thickness of subretinal fibrosis at fovea was 19.5 ± 44.1 and 92.3 ± 78.3 µm (p = 0.018). No differences were found in the presence and in the area of geographic atrophy, or fluid distribution, whereas thicknesses of serous pigment epithelial detachment (65.5 ± 99.5 and 12.9 ± 27.9 µm, p = 0.038) and neuroretina (204.2 ± 57.8 µm and 143.0 ± 43.7 µm, p = 0.006) were greater in the eyes of patients with physiological aMMP-8 levels compared to those with elevated aMMP-8 levels. CONCLUSION Elevated aMMP-8 levels may account for subretinal fibrosis formation in wet AMD.
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Affiliation(s)
- Minna Karesvuo
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland
- Health Services Dental Care, City of Helsinki, Helsinki, Finland
- Department of Ophthalmology, Mehiläinen Private Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Medicine and Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Raimo Tuuminen
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland
- Department of Ophthalmology, Mehiläinen Private Hospital, Helsinki, Finland
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland
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Leppilahti JM, Tervahartiala T, Kautiainen H, Räisänen I, Ahonen M, Uitto V, Sorsa T, Mäntylä P. Correlations between different protein species of oral rinse MMP-8 and patient-related factors. Clin Exp Dent Res 2023; 9:1021-1033. [PMID: 37877535 PMCID: PMC10728547 DOI: 10.1002/cre2.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/25/2023] [Accepted: 10/12/2023] [Indexed: 10/26/2023] Open
Abstract
OBJECTIVES The aim of this study is to examine correlations between different oral rinse matrix metalloproteinase (MMP)-8 protein species in western blot (WB) analysis, quantitative MMP-8 measurements, and patient-related factors. Elevated activated MMP-8 (aMMP-8) associate with periodontitis and a diagnostic point-of-care technology has been developed based on aMMP-8. In WB, different MMP-8 protein species can be analyzed. Relative abundancy of fragmented 20-25 kDa forms in WB has been associated with and reflects MMP-8 activation and related fragmentation and elevated quantitative aMMP-8 measurements. MATERIAL AND METHODS A random sample of 192 participants from a periodontal disease screening study was used for this study. Oral rinse samples for biomarker analyses were collected before clinical periodontal examinations. aMMP-8 immunofluorometric (IFMA) and WB analysis (utilizing the same monoclonal antibody, 8708), polymorphonuclear leukocyte (PMN) elastase activity test and tissue inhibitor of metalloproteinases (TIMP)-1 ELISA levels were performed from the oral rinse samples. Distinct MMP-8 protein species were differentiated in the WB analysis. Principal component (PC) analysis was conducted to explore correlation patterns between the different species. Adjusted correlation analysis between the extracted PCs of WB and aMMP-8 IFMA levels and multilevel regression analysis were conducted to explore if the other periodontal disease-related biomarkers and clinical surrogate measures and patient-related factors are co-variating with the extracted components. RESULTS Distinct correlation patterns between the MMP-8 protein species were observed. The first four PCs explained 89% of the whole variance in PC analysis. Statistically significant correlation (p < 0.05) were observed as follows: PC1 positively with 21 kDa (r = .69) and 25 kDa fragments (r = .55) and negatively with 150 kDa complexes (r = -.46). PC2 correlated with 45 (r = .70) and 55 kDa (r = .65) activated forms, PC3 with 70-80 kDa latent proforms (r = .63) and 90-100 kDa complexes (r = .67), and PC4 with 35 kDa fragments (r = .81). There were significant correlations between quantitative (IFMA) aMMP-8 measurements and PC1 (p < 0.001), PC2 (<0.05) and PC3 (<0.05) but not with PC4. In multilevel regression models age, PMN elastase activity, TIMP-1 levels, and a number of 4-5 mm periodontal pockets were associated with PC1, nonsmoking with PC2, age and PMN elastase activity with PC3, and age and smoking with PC4. CONCLUSIONS Relative abundancy of fragmented 21-25 kDa protein species was correlated with the quantitative aMMP-8 (IFMA) measurements, which is in line with previous results. Different patient-related factors (smoking, age, proteolytic activity) may modify the formation of different MMP-8 protein species in oral rinse samples and may cause variability in quantitative aMMP-8 measurement.
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Affiliation(s)
- Jussi M. Leppilahti
- Research Unit of Population Health, Faculty of MedicineUniversity of OuluOuluFinland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial DiseasesUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Hannu Kautiainen
- Primary Health Care UnitKuopio University HospitalKuopioFinland
- Folkhälsan Research CenterHelsinkiFinland
| | - Ismo Räisänen
- Department of Oral and Maxillofacial DiseasesUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Minna‐Maija Ahonen
- Unit of Dental Health Care ServicesKeski‐Uudenmaan hyvinvointialue (KEUSOTE)HyvinkääFinland
| | - Veli‐Jukka Uitto
- Department of Oral and Maxillofacial DiseasesUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Timo Sorsa
- Department of Oral and Maxillofacial DiseasesUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
- Division of Periodontology, Department of Dental MedicineKarolinska InstitutetStockholmSweden
| | - Päivi Mäntylä
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Oral and Maxillofacial DiseasesKuopio University HospitalKuopioFinland
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3
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Gupta S, Sahni V, Räisänen IT, Grigoriadis A, Sakellari D, Gieselmann DR, Sorsa T. Linking oral microbial proteolysis to aMMP-8 PoC diagnostics along with the stage and grade of periodontitis: A cross-sectional study. Oral Dis 2023; 29:285-289. [PMID: 34402146 DOI: 10.1111/odi.14008] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/07/2021] [Accepted: 08/12/2021] [Indexed: 12/18/2022]
Affiliation(s)
- Shipra Gupta
- Unit of Periodontology, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | | | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Andreas Grigoriadis
- 424 General Military Training Hospital, Thessaloniki, Greece
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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4
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Sahni V. Periodontal testing. Br Dent J 2022; 233:700. [DOI: 10.1038/s41415-022-5214-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gupta S, Mohindra R, Singla M, Khera S, Kumar A, Rathnayake N, Sorsa T, Pfützner A, Räisänen IT, Soni RK, Kanta P, Jain A, Gauba K, Goyal K, Singh MP, Ghosh A, Kajal K, Mahajan V, Suri V, Bhalla A. Validation of a noninvasive aMMP‐8 point‐of‐care diagnostic methodology in COVID‐19 patients with periodontal disease. Clin Exp Dent Res 2022; 8:988-1001. [PMID: 35818743 PMCID: PMC9350191 DOI: 10.1002/cre2.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/30/2022] [Accepted: 05/01/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives The aim of this study was to validate an active matrix metalloproteinase (MMP‐8) point‐of‐care diagnostic tool in COVID‐19 patients with periodontal disease. Subjects, Materials, and Methods Seventy‐two COVID‐19‐positive and 30 COVID‐19‐negative subjects were enrolled in the study. Demographic data were recorded, periodontal examination carried out, and chairside tests run for evaluating the expression of active MMP‐8 (aMMP‐8) in the site with maximum periodontal breakdown via gingival crevicular fluid sampling as well as via a mouth rinse‐based kit for general disease activity. In COVID‐19‐positive patients, the kits were run again once the patients turned COVID‐19 negative. Results The overall (n = 102) sensitivity/specificity of the mouthrinse‐based kits to detect periodontal disease was 79.41%/36.76% and that of site‐specific kits was 64.71%/55.88% while adjusting for age, gender, and smoking status increased the sensitivity and specificity (82.35%/76.47% and 73.53%/88.24, respectively). Receiver operating characteristic (ROC) analysis for the adjusted model revealed very good area under the ROC curve 0.746–0.869 (p < .001) and 0.740–0.872 (p < .001) (the aMMP‐8 mouth rinse and site‐specific kits, respectively). No statistically significant difference was observed in the distribution of results of aMMP‐8 mouth rinse test (p = .302) and aMMP‐8 site‐specific test (p = .189) once the subjects recovered from COVID‐19. Conclusions The findings of the present study support the aMMP‐8 point‐of‐care testing (PoCT) kits as screening tools for periodontitis in COVID‐19 patients. The overall screening accuracy can be further increased by utilizing adjunctively risk factors of periodontitis. The reported noninvasive, user‐friendly, and objective PoCT diagnostic methodology may provide a way of stratifying risk groups, deciding upon referrals, and in the institution of diligent oral hygiene regimens.
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Affiliation(s)
- Shipra Gupta
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Ritin Mohindra
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Mohita Singla
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Sagar Khera
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Amit Kumar
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Nilminie Rathnayake
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
- Department of Dental Medicine, Division of Periodontology Karolinska Institutet Huddinge Sweden
| | - Andreas Pfützner
- Clinical Research Department, Diabetes Center and Practice Pfützner Science and Health Institute Mainz Germany
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Roop K. Soni
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Poonam Kanta
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Akanksha Jain
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Krishan Gauba
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Kapil Goyal
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Mini P. Singh
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Arnab Ghosh
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Kamal Kajal
- Department of Anaesthesia and Intensive Care Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Varun Mahajan
- Department of Anaesthesia and Intensive Care Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Vikas Suri
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Ashish Bhalla
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
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Irwandi RA, Chiesa ST, Hajishengallis G, Papayannopoulos V, Deanfield JE, D’Aiuto F. The Roles of Neutrophils Linking Periodontitis and Atherosclerotic Cardiovascular Diseases. Front Immunol 2022; 13:915081. [PMID: 35874771 PMCID: PMC9300828 DOI: 10.3389/fimmu.2022.915081] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/13/2022] [Indexed: 01/02/2023] Open
Abstract
Inflammation plays a crucial role in the onset and development of atherosclerosis. Periodontitis is a common chronic disease linked to other chronic inflammatory diseases such as atherosclerotic cardiovascular disease (ASCVD). The mechanistic pathways underlying this association are yet to be fully understood. This critical review aims at discuss the role of neutrophils in mediating the relationship between periodontitis and ASCVD. Systemic inflammation triggered by periodontitis could lead to adaptations in hematopoietic stem and progenitor cells (HSPCs) resulting in trained granulopoiesis in the bone marrow, thereby increasing the production of neutrophils and driving the hyper-responsiveness of these abundant innate-immune cells. These alterations may contribute to the onset, progression, and complications of atherosclerosis. Despite the emerging evidence suggesting that the treatment of periodontitis improves surrogate markers of cardiovascular disease, the resolution of periodontitis may not necessarily reverse neutrophil hyper-responsiveness since the hyper-inflammatory re-programming of granulopoiesis can persist long after the inflammatory inducers are removed. Novel and targeted approaches to manipulate neutrophil numbers and functions are warranted within the context of the treatment of periodontitis and also to mitigate its potential impact on ASCVD.
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Affiliation(s)
- Rizky A. Irwandi
- Periodontology Unit, UCL Eastman Dental Institute, University College London, London, United Kingdom
| | - Scott T. Chiesa
- UCL Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - George Hajishengallis
- Department of Basic & Translational Sciences, Laboratory of Innate Immunity & Inflammation, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | | | - John E. Deanfield
- UCL Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Francesco D’Aiuto
- Periodontology Unit, UCL Eastman Dental Institute, University College London, London, United Kingdom
- *Correspondence: Francesco D’Aiuto,
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Sorsa T, Nwhator SO, Sakellari D, Grigoriadis A, Umeizudike KA, Brandt E, Keskin M, Tervahartiala T, Pärnänen P, Gupta S, Mohindra R, Bostanci N, Buduneli N, Räisänen IT. aMMP-8 Oral Fluid PoC Test in Relation to Oral and Systemic Diseases. FRONTIERS IN ORAL HEALTH 2022; 3:897115. [PMID: 35757444 PMCID: PMC9226345 DOI: 10.3389/froh.2022.897115] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/04/2022] [Indexed: 12/24/2022] Open
Abstract
The manuscript uses the previously published literature and highlights the benefits of active-matrix metalloproteinase (aMMP)-8 chairside/point-of-care (PoC) diagnostic tools as adjunctive measures in oral and systemic diseases. Previous studies suggest that as a biomarker, aMMP-8 is more precise than total MMP-8, MMP-9, MMP-2, MMP-3, MMP-13, MMP-7, MMP-1, calprotectin, myeloperoxidase (MPO), human neutrophil elastase (HNE), tissue inhibitor of matrix metalloproteinase (TIMP)-1, and bleeding of probing (BOP). Therefore, aMMP-8 could be implemented as the needed key biomarker for the new disease classification for both periodontitis and peri-implantitis. With a sensitivity to the tune of 75–85% and specificity in the range of 80–90%, lateral flow aMMP-8 PoC testing is comparable to catalytic protease activity assays for aMMP-8. The test can be further applied to estimate the glycemic status of an individual, to ascertain whether a person is at risk for COVID-19, in managing the oral side effects of radiotherapy carried in head and neck cancers, and in selected cases pertaining to reproductive health. In the future, aMMP-8 could find application as a potential systemic biomarker in diseases affecting the cardiovascular system, cancers, bacteremia, sepsis, diabetes, obesity, meningitis, as well as pancreatitis. The aMMP-8 PoCT is the first practical test in the emerging new dental clinical field, that is, oral clinical chemistry representing oral medicine, clinical chemistry, peri-implantology, and periodontology.
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Affiliation(s)
- Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Solna, Sweden
| | | | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Grigoriadis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
- 424 General Army Hospital, Thessaloniki, Greece
| | - Kehinde Adesola Umeizudike
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ella Brandt
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mutlu Keskin
- Oral and Dental Health Department, Altinbaş University, Istanbul, Turkey
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Shipra Gupta
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritin Mohindra
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nagihan Bostanci
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Solna, Sweden
| | - Nurcan Buduneli
- Department of Periodontology, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Ismo Tapani Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- *Correspondence: Ismo Tapani Räisänen
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Deng K, Wei S, Xu M, Shi J, Lai H, Tonetti MS. Diagnostic accuracy of active matrix metalloproteinase-8 point-of-care test for the discrimination of periodontal health status: Comparison of saliva and oral rinse samples. J Periodontal Res 2022; 57:768-779. [PMID: 35575900 DOI: 10.1111/jre.12999] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/25/2022] [Accepted: 04/29/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Assessment of biomarkers, specifically active matrix metalloproteinase-8 (aMMP-8), in saliva/oral rinses is a promising diagnostic approach for periodontal health and disease. Different oral fluids have specific advantages and limitations. This study investigates the effect of sampling different fluids on the accuracy of an aMMP-8 point of care test (POCT). METHODS Unstimulated whole saliva, a first, and a second oral rinse were sequentially taken from 95 consecutive adults. aMMP-8 was quantitatively determined with a lateral flow immunoassay (index test). A full-mouth periodontal examination was used to establish a diagnosis according to the 2017 World Workshop classification of periodontal diseases (reference standard). Diagnostic measures of the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity were assessed and compared. RESULTS In all oral fluid samples, periodontitis patients (N = 61) had significantly elevated aMMP-8 levels and increased test positivity rates compared with subjects with periodontal health or gingivitis (N = 34). The intra-individual comparison showed that aMMP-8 levels were significantly higher in 1st oral rinse compared with other samples (1st oral rinse > saliva = 2nd oral rinse, p = .007). The aMMP-8 test using 1st oral rinse exhibited the best accuracy for detecting periodontitis with a sensitivity of 80.3%, a specificity of 67.8% and an AUROC of 0.740. CONCLUSIONS A 30-second oral rinse with water omitting the prerinse provided the best accuracy to discriminate periodontal health and disease with an aMMP-8 POCT. This regimen seems promising for further studies in large representative populations to verify the current findings.
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Affiliation(s)
- Ke Deng
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Shimin Wei
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Min Xu
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Junyu Shi
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hongchang Lai
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Maurizio S Tonetti
- Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China.,European Research Group on Periodontology, Genoa, Italy
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9
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Umeizudike KA, Lähteenmäki H, Räisänen IT, Taylor JJ, Preshaw PM, Bissett SM, Tervahartiala T, O Nwhator S, Pärnänen P, Sorsa T. Ability of matrix metalloproteinase-8 biosensor, IFMA, and ELISA immunoassays to differentiate between periodontal health, gingivitis, and periodontitis. J Periodontal Res 2022; 57:558-567. [PMID: 35304757 PMCID: PMC9311725 DOI: 10.1111/jre.12985] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 01/18/2022] [Accepted: 03/06/2022] [Indexed: 12/29/2022]
Abstract
Objective The aim of this study was to determine the diagnostic utility of an MMP‐8 biosensor assay in differentiating periodontal health from gingivitis and periodontitis and compare it with an established time‐resolved immunofluorescence assay (IFMA) and enzyme‐linked immunosorbent assay (ELISA). Background Currently available antibody‐based assays display a wide variability in their ability to accurately measure matrix metalloproteinase‐8 (MMP‐8) levels in saliva. Methods Salivary MMP‐8 levels were analyzed in 189 systemically healthy participants using an antibody‐based biosensor prototype that operates using a surface acoustic wave technology and compared with IFMA and ELISA antibody assays. Participants were categorized into 3 groups: periodontal health (59), gingivitis (63), and periodontitis (67). A sub‐population of participants (n = 20) with periodontitis received periodontal treatment and were monitored for 6 months. Results All the assays demonstrated significantly higher salivary MMP‐8 concentrations in participants with periodontitis versus gingivitis, periodontitis versus health, and gingivitis versus health (all p < .05). The biosensor data demonstrated significant correlations with IFMA (r = .354, p < .001) and ELISA (r = .681, p < .001). Significant reductions in salivary MMP‐8 concentrations were detected by the biosensor (p = .030) and IFMA (p = .002) in participants with periodontitis 6 months after non‐surgical periodontal treatment. IFMA had the best sensitivity (89.2%) for detecting periodontitis and gingivitis versus health and 96.6% for detecting periodontitis versus health and gingivitis. The biosensor had an AUC value of 0.81 and diagnostic accuracy of 74.2% for differentiating periodontitis and gingivitis from health; an AUC value of 0.86 and diagnostic accuracy of 82.8% for periodontitis versus health and gingivitis. Conclusions The biosensor, IFMA, and ELISA assays differentiated between periodontal health, gingivitis, and periodontitis based on salivary MMP‐8 levels. Only the biosensor and, particularly, IFMA identified an effect of periodontal treatment in the participants with periodontitis. Our findings support the potential utility of salivary oral fluid aMMP‐8‐based point‐of‐care technology in the future of periodontal diagnostics.
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Affiliation(s)
- Kehinde Adesola Umeizudike
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Hanna Lähteenmäki
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - John J Taylor
- School of Dental Sciences and Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Susan M Bissett
- School of Dental Sciences and Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Solomon O Nwhator
- Department of Preventive and Community Dentistry, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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10
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Rodrigues KE, Azevedo A, Gonçalves PR, Pontes MHB, Alves GM, Oliveira RR, Amarante CB, Issa JPM, Gerlach RF, Prado AF. Doxycycline Decreases Atherosclerotic Lesions in the Aorta of ApoE-⁄- and Ovariectomized Mice with Correlation to Reduced MMP-2 Activity. Int J Mol Sci 2022; 23:ijms23052532. [PMID: 35269673 PMCID: PMC8910467 DOI: 10.3390/ijms23052532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/26/2022] [Accepted: 01/30/2022] [Indexed: 02/05/2023] Open
Abstract
Atherogenic events promote changes in vessel walls, with alteration of the redox state, and increased activity of matrix metalloproteinases (MMPs). Thus, this study aims to evaluate aortic remodeling, MMP activity, and reactive oxygen species (ROS) levels after treatment with doxycycline in ApoE-⁄- and ovariectomized mice (OVX). Female ApoE-⁄--knockout mice (5 weeks) were submitted to ovariectomy surgery to induce experimental menopause. They then received chow enriched with 1% cholesterol to induce hypercholesterolemia. The animals were divided into two experimental groups: ApoE-⁄-/OVX vehicle and ApoE-⁄-/OVX doxycycline (30 mg/kg) administered by gavage once a day for 28 days (15th to the 18th week of life). Blood samples were collected to measure total cholesterol and fractions. The aorta was used for morphometry and to measure the activity and expression of MMP-2 and ROS levels. The ApoE-⁄-/OVX doxycycline group showed no change in total and fraction cholesterol levels. However, there was a reduction in ROS levels, MMP-2 expression, and activity that correlated with a decrease in atherosclerotic lesions relative to the ApoE-⁄-/OVX vehicle (p > 0.05). Therefore, we conclude that doxycycline in ApoE-⁄-/OVX animals promotes a reduction in atherosclerotic lesions by reducing ROS and MMP-2 activity and expression.
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Affiliation(s)
- Keuri E. Rodrigues
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
| | - Aline Azevedo
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Faculty of Medicine of Ribeirão Preto, University of Sao Paulo, Ribeirão Preto 14049-900, SP, Brazil;
| | - Pricila R. Gonçalves
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
| | - Maria H. B. Pontes
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
| | - Gustavo M. Alves
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
| | - Ruan R. Oliveira
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
| | - Cristine B. Amarante
- Coordination of Earth Sciences and Ecology, Museu Paraense Emílio Goeldi, Belem 66077-830, PA, Brazil;
| | - João P. M. Issa
- Department of Basic and Oral Biology, School of Dentistry of Ribeirao Preto, University of Sao Paulo (FORP/USP), Ribeirao Preto 14040-904, SP, Brazil; (J.P.M.I.); (R.F.G.)
| | - Raquel F. Gerlach
- Department of Basic and Oral Biology, School of Dentistry of Ribeirao Preto, University of Sao Paulo (FORP/USP), Ribeirao Preto 14040-904, SP, Brazil; (J.P.M.I.); (R.F.G.)
| | - Alejandro F. Prado
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
- Correspondence:
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11
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Sopi M, Koçani F, Bardhoshi M, Meqa K. The Effect of Periodontal Therapy on the Level of MMP-8 in Patients with Chronic Periodontitis. Eur J Dent 2022; 17:70-75. [PMID: 35172347 PMCID: PMC9949935 DOI: 10.1055/s-0041-1742132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The complete removal of bacterial plaque and their endotoxins in deeper areas of periodontal pockets is often difficult to achieve with conventional methods such as periodontal pocket curettage. An alternative to these methods that recently gained popularity in periodontology is the diode laser, with its antibacterial effect, angiogenesis promotion as advantages. MATERIALS AND METHODS This study included 100 patients diagnosed with chronic periodontitis, with periodontal pockets up to 6 mm, and who were divided into two groups: patients treated with basic therapy and diode laser application, and patients treated with basic therapy and with flap surgery. The clinical periodontal evaluation was done before the treatment and 6 months after the treatment. Evaluation of matrix metalloproteinase (MMP)-8 as an inflammatory indicator in gingival exudate was done with dipstick immunoassay test before the treatment and 6 months later. RESULTS This study showed a more pronounced improvement of periodontal clinical parameters, as well as a decrease in MMP-8 values in gingival exudate in the laser-treated group compared with the surgically treated group. CONCLUSION The results of this study are encouraging for the use of the diode laser as a noninvasive method in the treatment of periodontal pathologies.
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Affiliation(s)
- Mirlinda Sopi
- Department of Periodontology and Oral Medicine, Dentistry School, University of Pristina, Pristina, Kosovo
| | - Ferit Koçani
- Department of Dental Pathology and Endodontics, Dentistry School, University of Pristina, Pristina, Kosovo
| | - Merita Bardhoshi
- Department of Oro-Maxillofacial Surgery, University of Medicine, Tirana, Tirana, Albania
| | - Kastriot Meqa
- Department of Periodontology and Oral Medicine, Dentistry School, University of Pristina, Pristina, Kosovo,Address for correspondence Kastriot Meqa, DDS, MSc, PhD Department of Periodontology and Oral Medicine, Dentistry School, University of PristinaRrethi I Spitalit Street, NN, QKSUK, Pristina 10000Kosovo
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12
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Laugisch O, Auschill TM, Heumann C, Sculean A, Arweiler NB. Clinical Evaluation of a New Electronic Periodontal Probe: A Randomized Controlled Clinical Trial. Diagnostics (Basel) 2021; 12:diagnostics12010042. [PMID: 35054209 PMCID: PMC8774924 DOI: 10.3390/diagnostics12010042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 01/19/2023] Open
Abstract
Precise measurements of periodontal parameters (such as pocket depths: PPD, gingival margins: GM) are important for diagnosis of periodontal disease and its treatment. Most examiners use manual millimeter-scaled probes, dependent on adequate pressure and correct readouts. Electronic probes aim to objectify and facilitate the diagnostic process. This randomized controlled trial compared measurements of a standard manual (MP) with those of an electronic pressure-sensitive periodontal probe (EP) and its influence on patients' acceptance and practicability. In 20 patients (2436 measuring points) PPD and GM were measured either with MP or EP by professionals with different levels of experience: dentist (10 patients), 7th and 10th semester dental students (5 patients each). Time needed was measured in minutes and patients' subjective pain was evaluated by visual analogue scale. Differences were analyzed using the generalized estimating equations approach (GEE) and paired Wilcoxon tests. Mean PPD varied with ΔPPD 0.38 mm between both probes, which was significant (p < 0.001), but GM did not (ΔREC 0.07 mm, p = 0.197). There was a statistically significant correlation of both probes (Spearman's rho correlation coefficient GM: 0.674, PPD: 0.685). Differences can be considered robust (no deviation in either direction). The comparison of time needed and pain sensitivity did not result in statistically significant differences (p > 0.05).
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Affiliation(s)
- Oliver Laugisch
- Department of Periodontology and Peri-Implant Diseases, Philipps-University, 35037 Marburg, Germany; (O.L.); (T.M.A.)
| | - Thorsten M. Auschill
- Department of Periodontology and Peri-Implant Diseases, Philipps-University, 35037 Marburg, Germany; (O.L.); (T.M.A.)
| | - Christian Heumann
- Department of Statistics, Ludwig-Maximilians-University Munich, 80539 Munich, Germany;
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland;
| | - Nicole B. Arweiler
- Department of Periodontology and Peri-Implant Diseases, Philipps-University, 35037 Marburg, Germany; (O.L.); (T.M.A.)
- Correspondence:
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13
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Hernández M, Baeza M, Räisänen IT, Contreras J, Tervahartiala T, Chaparro A, Sorsa T, Hernández-Ríos P. Active MMP-8 Quantitative Test as an Adjunctive Tool for Early Diagnosis of Periodontitis. Diagnostics (Basel) 2021; 11:diagnostics11081503. [PMID: 34441437 PMCID: PMC8394100 DOI: 10.3390/diagnostics11081503] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 12/16/2022] Open
Abstract
Periodontitis is a host-mediated bacterial disease that affects the tooth attachment apparatus. Metalloproteinase-8 (MMP-8), a validated biomarker, could aid in clinical diagnosis. This study aimed to evaluate the diagnostic performance of active (a) MMP-8 immunotest versus total (t) MMP-8 ELISA for quantitative real-time diagnosis and assessment of periodontitis severity at the site level. Gingival crevicular fluid (GCF) was sampled from 30 healthy, 42 mild, and 59 severe periodontitis sites from thirty-one volunteers. MMP-8 concentrations were determined by time-resolved immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using the STATA package. Both active and total MMP-8-based methods discriminated among sites according to periodontal diagnosis and severity, with a positive correlation between the two tests (p < 0.001). (a) MMP-8 models showed the best performance in receiver operating characteristic (ROC) curves to discriminate between healthy and periodontitis sites (area under the curve [AUC] = 0.89), while (t) MMP-8 demonstrated a high diagnostic precision in the detection of mild from severe periodontitis sites (AUC ≥ 0.80). The use of (a) MMP-8 and (t) MMP-8 could represent a useful adjunctive tool for periodontitis diagnosis and severity. These results support the applicability of new point-of-care methods in the monitoring of high-risk periodontal patients.
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Affiliation(s)
- Marcela Hernández
- Laboratory of Periodontal Biology, Department of Oral Pathology and Medicine, Faculty of Dentistry, University of Chile, Santiago 8380544, Chile;
| | - Mauricio Baeza
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago 8380544, Chile; (M.B.); (J.C.)
- School of Public Health, Faculty of Medicine, University of Chile, Santiago 7510040, Chile
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (I.T.R.); (T.T.); (T.S.)
| | - Johanna Contreras
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago 8380544, Chile; (M.B.); (J.C.)
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (I.T.R.); (T.T.); (T.S.)
| | - Alejandra Chaparro
- Department of Periodontology, Centro de Investigación e Innovación Biomédica (CIIB), Faculty of Dentistry, Universidad de Los Andes, Santiago 7620001, Chile;
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (I.T.R.); (T.T.); (T.S.)
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, 14152 Huddinge, Sweden
| | - Patricia Hernández-Ríos
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago 8380544, Chile; (M.B.); (J.C.)
- Correspondence: ; Tel.: +56-2-2978-1839
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14
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Sorsa T, Grigoriadis A, Sakellari D, Gupta S, Sahni V, Tervahartiala T, Räisänen IT. On the accuracy, sensitivity, and grading of mouthrinse active matrix metalloproteinase-8 (aMMP-8) point-of-care testing (POCT). J Clin Periodontol 2021; 48:1495-1498. [PMID: 34312914 DOI: 10.1111/jcpe.13521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/11/2021] [Indexed: 02/06/2023]
Affiliation(s)
- Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland.,Department of Oral Diseases, Karolinska Institutet, Huddinge, Sweden
| | - Andreas Grigoriadis
- Department of Periodontology, 424 General Army Hospital, Thessaloniki, Greece.,Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Shipra Gupta
- Unit of Periodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Vaibhav Sahni
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland
| | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland
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15
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Deng K, Pelekos G, Jin L, Tonetti MS. Reply to letter to the editor: "Diagnostic accuracy of a point-of-care aMMP-8 test in the discrimination of periodontal health and disease". J Clin Periodontol 2021; 48:1499-1500. [PMID: 34265866 DOI: 10.1111/jcpe.13522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Ke Deng
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.,Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Ninth People' Hospital, College of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - George Pelekos
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Lijian Jin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Maurizio S Tonetti
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.,Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Ninth People' Hospital, College of Medicine, Shanghai Jiao Tong University, Shanghai, China.,European Research Group on Periodontology, Genoa, Italy
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