Gürsoy Ulvi Kahraman, Pussinen Pirkko J, Salomaa Veikko, Syrjäläinen Sanna, Könönen Eija
a Periodontology, Institute of Dentistry , University of Turku , Turku , Finland.
b Oral and Maxillofacial Diseases, Faculty of Medicine , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
Acta Odontol Scand. 2018 Oct;76(7):493-496. doi: 10.1080/00016357.2018.1441436. Epub 2018 Feb 20.
Aim was to analyze the diagnostic ability of cumulative risk score (CRS), which uses salivary levels of Porphyromonas gingivalis, interleukin (IL)-1β, and matrix metalloproteinase (MMP)-8 in an adaptive design, compared to previously reported thresholds of each marker alone.
Oral and general health information of 463 participants were included in the analysis. Having the percentage of bleeding on probing (BOP) > 25%, having at least two sites with probing pocket depth (PPD) of 4-5 mm or having at least one tooth with alveolar bone loss (ABL) of at least 1/3 of the root length were accepted as outcome variables. Being above the salivary threshold concentrations of P. gingivalis, IL-1β, and MMP-8 and CRS values were used as explanatory variables. Receiver operating characteristics (ROC) producing an area under the curve (AUC) and multinomial regression analysis were used in statistical analysis.
CRS provided AUCs larger than any other tested biomarker threshold. Sensitivity and specificity of CRS for detecting clinical markers of periodontitis were acceptable, and a strong association was observed between the highest CRS score and having at least two sites with PPD of 4-5 mm.
CRS brings additional power over fixed thresholds of single biomarkers in detecting periodontitis.
旨在分析累积风险评分（CRS）的诊断能力，该评分在适应性设计中使用牙龈卟啉单胞菌、白细胞介素（IL）-1β和基质金属蛋白酶（MMP）-8的唾液水平，并与之前单独报道的每个标志物的阈值进行比较。
分析纳入了463名参与者的口腔和全身健康信息。探诊出血（BOP）百分比>25%、至少有两个探诊袋深度（PPD）为4 - 5毫米的部位或至少有一颗牙齿的牙槽骨丧失（ABL）至少为牙根长度的1/3被视为结局变量。牙龈卟啉单胞菌、IL-1β和MMP-8的唾液阈值浓度以上以及CRS值用作解释变量。统计分析采用生成曲线下面积（AUC）的受试者工作特征（ROC）和多项回归分析。
CRS提供的AUC大于任何其他测试的生物标志物阈值。CRS检测牙周炎临床标志物的敏感性和特异性是可接受的，并且在最高CRS评分与至少有两个PPD为4 - 5毫米的部位之间观察到强关联。
在检测牙周炎方面，CRS比单一生物标志物的固定阈值具有更大的优势。
