title: Combining salivary pathogen and serum antibody levels improves their diagnostic ability in detection of periodontitis.
abstract: BACKGROUND
  Initiation and progression of periodontitis correlates with increased quantities of periodontitis-associated bacteria in periodontal biofilms. In the present study, the aim is to measure Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis amounts in saliva and their antibody (immunoglobulin [Ig]A and IgG) levels in serum and evaluate their diagnostic abilities, together or alone, in chronic periodontitis.
  
  
  METHODS
  The study population comprised 230 Finnish dentate adults: 84 with generalized chronic periodontitis (GCP), 65 with localized chronic periodontitis (LCP), and 81 controls without periodontitis. General and oral health information was obtained by questionnaires, interviews, and clinical and radiographic examinations. Salivary and serum samples were analyzed by quantitative single copy gene-based real-time polymerase chain reaction and multiserotype enzyme-linked immunosorbent assay, respectively.
  
  
  RESULTS
  Pathogen carriers suffered mostly from GCP and seldom from LCP. A. actinomycetemcomitans and P. gingivalis quantities in saliva were strongly associated with corresponding serum IgA and IgG values (P <0.001) and with severity of disease (P <0.001). P. gingivalis exhibited more straightforward associations among salivary bacterial burdens, corresponding antibody formation, and periodontitis severity than A. actinomycetemcomitans. The combination of information on age, sex, smoking, and P. gingivalis results provided an area under the curve of 0.817 (95% confidence interval 0.76 to 0.87, P <0.001) for GCP.
  
  
  CONCLUSIONS
  The combination of saliva P. gingivalis quantity with pathogen-specific host response may be used to diagnose periodontitis with high accuracy.
authors: Institute of Dentistry, University of Helsinki, Helsinki, Finland.
authors: John M
authors: JM
authors: Liljestrand
authors: Ulvi K
authors: UK
authors: Gursoy
authors: Kati
authors: K
authors: Hyvärinen
authors: Timo
authors: T
authors: Sorsa
authors: Anna L
authors: AL
authors: Suominen
authors: Eija
authors: E
authors: Könönen
authors: Pirkko J
authors: PJ
authors: Pussinen
mesh_terms: D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000276:immunology / Q000302:isolation & purification*; D016301:Alveolar Bone Loss / Q000145:classification; D000907:Antibodies, Bacterial / Q000097:blood*; D058491:Bacterial Load; D055113:Chronic Periodontitis / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D004522:Educational Status; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D016966:Porphyromonas gingivalis / Q000276:immunology / Q000302:isolation & purification*; D012372:ROC Curve; D060888:Real-Time Polymerase Chain Reaction; D012463:Saliva / Q000382:microbiology*; D012680:Sensitivity and Specificity; D012907:Smoking
chemical_list: D000907:Antibodies, Bacterial; D007070:Immunoglobulin A; D007074:Immunoglobulin G