Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
Department of Oral Implantology, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology; National Center of Stomatology; National Clinical Research Center of Oral Diseases; Shanghai key Laboratory of Stomatology, Shanghai, China.
J Clin Periodontol. 2021 Aug;48(8):1051-1065. doi: 10.1111/jcpe.13485. Epub 2021 Jun 10.
To assess the diagnostic utility of an oral rinse active matrix metalloproteinase-8 (aMMP-8) point-of-care test (POCT) for differentiating periodontal health, gingivitis, as well as different stages and grades of periodontitis.
MATERIALS & METHODS: The aMMP-8 index test was undertaken in 408 consecutive adults, followed by a full-mouth periodontal examination. The reference standard was the 2017 World Workshop classification of periodontal diseases. Sensitivity, specificity, and the area under the receiver operating characteristic curve (AUROC) were assessed.
68.6% of the participants were diagnosed with periodontitis, including Stages I (15.9%), II (15.9%), III (29.7%) and IV (7.1%). A positive aMMP-8 POCT was associated with periodontitis after adjusting for age, gender, tobacco smoking and systemic diseases, while it was unable to differentiate among the stages/grades of periodontitis and between gingivitis/periodontal health. This test showed a sensitivity of 33.2% and a specificity of 93.0% for detecting periodontitis (threshold level >10 ng/ml). The levels of aMMP-8 adjusted by the number of teeth present (aMMP-8/NTP) performed better for periodontitis (sensitivity: 67.1%; specificity: 68.8%). Notably, aMMP-8/NTP were strongly predictive for Stage IV periodontitis (threshold level =0.4312 ng/ml) (sensitivity: 89.7%; specificity: 73.6%; and AUROC: 0.856). The test performance greatly improved in combination with age and smoking, with a sensitivity of 82.5%, a specificity of 84.4%, and an AUROC of 0.883.
This aMMP-8 POCT is able to detect periodontitis with better specificity than sensitivity across the spectrum of its severity. This test may be useful for periodontal screening in conjunction with subject characteristics and/or other sensitive screening tools. Further validation studies are needed.
评估一种口腔冲洗活性基质金属蛋白酶-8（aMMP-8）即时检测（POCT）用于区分牙周健康、牙龈炎以及不同阶段和严重程度牙周炎的诊断效用。
对 408 名连续就诊的成年人进行了 aMMP-8 指数检测，随后进行了全口牙周检查。参考标准为 2017 年世界牙周病工作组分类。评估了敏感性、特异性和受试者工作特征曲线下面积（AUROC）。
68.6%的参与者被诊断为牙周炎，包括 I 期（15.9%）、II 期（15.9%）、III 期（29.7%）和 IV 期（7.1%）。在调整年龄、性别、吸烟和全身疾病后，aMMP-8 POCT 阳性与牙周炎相关，但无法区分牙周炎的阶段/严重程度以及牙龈炎/牙周健康。该检测对牙周炎的敏感性为 33.2%，特异性为 93.0%（阈值水平>10ng/ml）。根据牙齿数量调整的 aMMP-8（aMMP-8/NTP）对牙周炎的检测效果更好（敏感性：67.1%；特异性：68.8%）。值得注意的是，aMMP-8/NTP 对 IV 期牙周炎具有很强的预测能力（阈值水平=0.4312ng/ml）（敏感性：89.7%；特异性：73.6%；AUROC：0.856）。该检测与年龄和吸烟相结合时，检测性能大大提高，敏感性为 82.5%，特异性为 84.4%，AUROC 为 0.883。
该 aMMP-8 POCT 能够检测牙周炎，其严重程度特异性优于敏感性。该检测可能与患者特征和/或其他敏感筛查工具结合用于牙周病筛查。需要进一步的验证研究。
