Salivary biomarkers for predicting the progression of chronic periodontitis.
OBJECTIVE
Predicting the progression of periodontitis would allow for targeted supportive periodontal therapy. The purpose of this study was to determine the usefulness of salivary biomarkers for predicting the progression of periodontitis.


METHODS
Eighty-five chronic periodontitis patients were enrolled in an 18-month longitudinal study. Amongst them, 57 experienced progression of periodontitis, indicated at the end of the 18 months by at least one site with >3mm loss of attachment compared with baseline. We determined the levels of aspartate aminotransferase, alanine aminotransferase (ALT), lactate dehydrogenase, alkaline phosphatase and free haemoglobin as biomarkers, as well as the counts of Porphyromonas gingivalis, Prevotella intermedia and Tannerella forsythia, which represented the periodontal bacteria, in the stimulated saliva. The Mann-Whitney U test was used to compare patients with and without progression. After categorising the diagnostic values, the chi-square test was applied.


RESULTS
Counts and ratios (ratio to total bacteria) of P. gingivalis and P. intermedia were found to be significant predictors of the progression of periodontitis. To increase prediction accuracy, combination analyses were performed. The combination of ALT level and the P. gingivalis ratio showed the highest likelihood (p<0.001, sensitivity 0.40, specificity 0.96, likelihood 11.30).


CONCLUSIONS
Our findings suggest that salivary ALT level and the P. gingivalis ratio may be potential indicators for the progression of periodontitis. Such a salivary test could be a useful diagnostic tool for predicting periodontal disease progression.
Department of Translational Research, Tsurumi University School of Dental Medicine, Kanagawa, Japan.
Yoshiaki
Y
Nomura
Yasuko
Y
Shimada
Nobuhiro
N
Hanada
Yukihiro
Y
Numabe
Kyuichi
K
Kamoi
Tsutomu
T
Sato
Kazuhiro
K
Gomi
Takashi
T
Arai
Koji
K
Inagaki
Mitsuo
M
Fukuda
Toshihide
T
Noguchi
Hiromasa
H
Yoshie
D000368:Aged; D015415:Biomarkers / Q000032:analysis; D055113:Chronic Periodontitis / Q000175:diagnosis* / Q000382:microbiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000382:microbiology*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000382:microbiology*; D010519:Periodontium / Q000382:microbiology* / Q000503:physiopathology; D012372:ROC Curve; D012463:Saliva / Q000737:chemistry / Q000382:microbiology*; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D015415:Biomarkers