Targeted salivary biomarkers for discrimination of periodontal health and disease(s).
Generally, clinical parameters are used in dental practice for periodontal disease, yet several drawbacks exist with the clinical standards for addressing the needs of the public at large in determining the current status/progression of the disease, and requiring a significant amount of damage before these parameters can document disease. Therefore, a quick, easy and reliable method of assessing and monitoring periodontal disease should provide important diagnostic information that improves and speeds treatment decisions and moves the field closer to individualized point-of-care diagnostics.


OBJECTIVE
This report provides results for a saliva-based diagnostic approach for periodontal health and disease based upon the abundance of salivary analytes coincident with disease, and the significant progress already made in the identification of discriminatory salivary biomarkers of periodontitis.


METHODS
We evaluated biomarkers representing various phases of periodontitis initiation and progression (IL-1ß, IL-6, MMP-8, MIP-1α) in whole saliva from 209 subjects categorized with periodontal health, gingivitis, and periodontitis.


RESULTS
Evaluation of the salivary analytes demonstrated utility for individual biomarkers to differentiate periodontitis from health. Inclusion of gingivitis patients into the analyses provided a more robust basis to estimate the value of each of these analytes. Various clinical and statistical approaches showed that pairs or panels of the analytes were able to increase the sensitivity and specificity for the identification of disease.


CONCLUSIONS
Salivary concentrations of IL-1ß, IL-6, MMP-8, MIP-1α alone and in combination are able to distinguish health from gingivitis and periodontitis. The data clearly demonstrated a heterogeneity in response profiles of these analytes that supports the need for refinement of the standard clinical classifications if we are to move toward precision/personalized dentistry for the twenty-first century.
Center for Oral Health Research, College of Dentistry, University of Kentucky Lexington, KY, USA.
Jeffrey L
JL
Ebersole
Division of Biomedical Informatics, College of Public Health, University of Kentucky Lexington, KY, USA.
Radhakrishnan
R
Nagarajan
Department of Statistics, College of Arts and Sciences, University of Kentucky Lexington, KY, USA.
David
D
Akers
Center for Oral Health Research, College of Dentistry, University of Kentucky Lexington, KY, USA ; Division of Oral Diagnosis, Oral Medicine and Oral Radiology, College of Dentistry, University of Kentucky Lexington, KY, USA.
Craig S
CS
Miller
D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D016022:Case-Control Studies; D016207:Cytokines / Q000032:analysis*; D005260:Female; D005891:Gingivitis / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000175:diagnosis* / Q000473:pathology*; D012463:Saliva / Q000737:chemistry*; D012680:Sensitivity and Specificity; D055815:Young Adult
D015415:Biomarkers; D016207:Cytokines
MMP-8; cytokines; periodontitis; personalized medicine; saliva