Cumulative use of salivary markers with an adaptive design improves detection of periodontal disease over fixed biomarker thresholds |
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| Authors: | Ulvi Kahraman Gürsoy Pirkko J. Pussinen Veikko Salomaa Sanna Syrjäläinen Eija Könönen |
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| Affiliation: | 1. Periodontology, Institute of Dentistry, University of Turku, Turku, Finland;2. Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;3. National Institute for Health and Welfare, Helsinki, Finland |
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| Abstract: | Objective: Aim was to analyze the diagnostic ability of cumulative risk score (CRS), which uses salivary levels of Porphyromonas gingivalis, interleukin (IL)-1β, and matrix metalloproteinase (MMP)-8 in an adaptive design, compared to previously reported thresholds of each marker alone.Materials and Methods: Oral and general health information of 463 participants were included in the analysis. Having the percentage of bleeding on probing (BOP)?>?25%, having at least two sites with probing pocket depth (PPD) of 4–5?mm or having at least one tooth with alveolar bone loss (ABL) of at least 1/3 of the root length were accepted as outcome variables. Being above the salivary threshold concentrations of P. gingivalis, IL-1β, and MMP-8 and CRS values were used as explanatory variables. Receiver operating characteristics (ROC) producing an area under the curve (AUC) and multinomial regression analysis were used in statistical analysis.Results: CRS provided AUCs larger than any other tested biomarker threshold. Sensitivity and specificity of CRS for detecting clinical markers of periodontitis were acceptable, and a strong association was observed between the highest CRS score and having at least two sites with PPD of 4–5?mm.Conclusion: CRS brings additional power over fixed thresholds of single biomarkers in detecting periodontitis. |
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| Keywords: | Biomarker interleukin-1β matrix metalloproteinase-8 periodontitis porphyromonas gingivalis saliva |
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