Periodontitis progression can be predicted by salivary biomarkers
MedWire News: The presence of specific salivary biomarkers can predict progression of periodontitis, and may be a useful diagnostic tool, research from Japan suggests.
A number of salivary biomarkers have been found to be useful in predicting the course of periodontitis, including enzymes that are thought to be released from damaged tissue. In addition, several bacterial species have been shown to be associated with the clinical signs of periodontitis.
The availability of a noninvasive method to identify patients at risk for progression of periodontitis would be of great value to clinical practice, and allow targeting of supportive periodontal therapy, say the researchers.
In the current study, published in Archives of Oral Biology, Hiromasa Yoshie (Niigata University Graduate School of Medical and Dental Sciences) and colleagues evaluated the usefulness of salivary biomarkers and bacterial counts in the determination of disease progression in patients with chronic periodontitis.
Japanese patients with chronic periodontitis (n=85) were recruited to the study between January and December 2004. Patients were on average 60 years of age, and the majority were female (75%). Patients were followed up for 18 months, receiving clinical examinations every 6 months.
Progression of periodontal disease was defined as at least one site with more than 3 mm of clinical attachment loss compared with baseline.
Fifty-seven patients (67%) exhibited disease progression. Of the salivary biomarkers tested neither aspartate transaminase, alanine transaminase (ALT), alkaline phosphatase, lactate dehydrogenase nor free hemoglobin were individually able to predict progression of periodontitis in these patients.
Salivary counts of both Porphyromonas gingivalis and Prevotella intermedia were significantly associated with periodontitis progression. P. gingivalis provided a sensitivity of 0.68, a specificity of 0.68, and the positive and negative predictive values were 0.81 and 0.51 respectively. The corresponding values for P. intermedia were 0.67, 0.64, 0.79 and 0.49.
To try to improve the accuracy of prediction, combinations of salivary biomarkers and bacterial species were analyzed. The combination of P. gingivalis ratio (P. gingivalis count divided by the total bacterial count) with ALT level provided the best significant predictive capacity with a sensitivity of 0.40, a specificity of 0.96, positive predictive value of 0.96 and a negative predictive value of 0.44.
Commenting on their results, the authors say "Our findings suggest that the salivary ALT level and the P. gingivalis ratio may be useful biomarkers for predicting the progression of periodontal disease during supportive periodontal therapy.
Salivary testing could therefore represent a noninvasive, sensitive and useful test for multi-factorial risk assessment models for subsequent periodontal disease progression."
By Iain Bartlett