title: Crevicular fluid biomarkers and periodontal disease progression.
abstract: OBJECTIVE
  Assess the ability of a panel of gingival crevicular fluid (GCF) biomarkers as predictors of periodontal disease progression (PDP).
  
  
  METHODS
  In this study, 100 individuals participated in a 12-month longitudinal investigation and were categorized into four groups according to their periodontal status. GCF, clinical parameters and saliva were collected bi-monthly. Subgingival plaque and serum were collected bi-annually. For 6 months, no periodontal treatment was provided. At 6 months, patients received periodontal therapy and continued participation from 6 to 12 months. GCF samples were analysed by ELISA for MMP-8, MMP-9, Osteoprotegerin, C-reactive Protein and IL-1β. Differences in median levels of GCF biomarkers were compared between stable and progressing participants using Wilcoxon Rank Sum test (p = 0.05). Clustering algorithm was used to evaluate the ability of oral biomarkers to classify patients as either stable or progressing.
  
  
  RESULTS
  Eighty-three individuals completed the 6-month monitoring phase. With the exception of GCF C-reactive protein, all biomarkers were significantly higher in the PDP group compared to stable patients. Clustering analysis showed highest sensitivity levels when biofilm pathogens and GCF biomarkers were combined with clinical measures, 74% (95% CI = 61, 86).
  
  
  CONCLUSIONS
  Signature of GCF fluid-derived biomarkers combined with pathogens and clinical measures provides a sensitive measure for discrimination of PDP (ClinicalTrials.gov NCT00277745).
authors.affiliation: Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
authors.forename: Janet S
authors.initials: JS
authors.lastname: Kinney
authors.affiliation: Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA.|Currently, Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Thiago
authors.initials: T
authors.lastname: Morelli
authors.affiliation: Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
authors.forename: Min
authors.initials: M
authors.lastname: Oh
authors.affiliation: Biostatistics Department, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Braun
authors.affiliation: Currently, Department of Periodontology, School of Dental Medicine, University of Berne, Freiburgstrasse 7, CH-3010 Bern, Switzerland.
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Ramseier
authors.affiliation: Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
authors.forename: Jim V
authors.initials: JV
authors.lastname: Sugai
authors.affiliation: Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA.|Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA.
authors.forename: William V
authors.initials: WV
authors.lastname: Giannobile
mesh_terms: D018441:Biofilms; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D055113:Chronic Periodontitis / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D015331:Cohort Studies; D003773:Dental Plaque / Q000382:microbiology; D012534:Dental Scaling / Q000379:methods; D018450:Disease Progression; D005500:Follow-Up Studies; D005544:Forecasting; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D005891:Gingivitis / Q000628:therapy; D006801:Humans; D053583:Interleukin-1beta / Q000032:analysis; D008137:Longitudinal Studies; D020784:Matrix Metalloproteinase 8 / Q000032:analysis; D020780:Matrix Metalloproteinase 9 / Q000032:analysis; D053244:Osteoprotegerin / Q000032:analysis; D010518:Periodontitis / Q000097:blood / Q000503:physiopathology* / Q000628:therapy; D016745:Root Planing / Q000379:methods; D012463:Saliva / Q000737:chemistry; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D053583:Interleukin-1beta; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human; D002097:C-Reactive Protein; C488762:MMP8 protein, human; D020784:Matrix Metalloproteinase 8; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9
keywords: biomarkers; disease progression; gingival crevicular fluid; longitudinal; periodontitis