Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Shanghai Perio-Implant Innovation Center, School of Medicine, Ninth People' Hospital, Shanghai Jiao Tong University, Shanghai, China.
European Research Group on Periodontology, Genoa, Italy.
J Periodontal Res. 2022 Aug;57(4):768-779. doi: 10.1111/jre.12999. Epub 2022 May 16.
Assessment of biomarkers, specifically active matrix metalloproteinase-8 (aMMP-8), in saliva/oral rinses is a promising diagnostic approach for periodontal health and disease. Different oral fluids have specific advantages and limitations. This study investigates the effect of sampling different fluids on the accuracy of an aMMP-8 point of care test (POCT).
Unstimulated whole saliva, a first, and a second oral rinse were sequentially taken from 95 consecutive adults. aMMP-8 was quantitatively determined with a lateral flow immunoassay (index test). A full-mouth periodontal examination was used to establish a diagnosis according to the 2017 World Workshop classification of periodontal diseases (reference standard). Diagnostic measures of the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity were assessed and compared.
In all oral fluid samples, periodontitis patients (N = 61) had significantly elevated aMMP-8 levels and increased test positivity rates compared with subjects with periodontal health or gingivitis (N = 34). The intra-individual comparison showed that aMMP-8 levels were significantly higher in 1st oral rinse compared with other samples (1 oral rinse > saliva = 2 oral rinse, p = .007). The aMMP-8 test using 1st oral rinse exhibited the best accuracy for detecting periodontitis with a sensitivity of 80.3%, a specificity of 67.8% and an AUROC of 0.740.
A 30-second oral rinse with water omitting the prerinse provided the best accuracy to discriminate periodontal health and disease with an aMMP-8 POCT. This regimen seems promising for further studies in large representative populations to verify the current findings.
评估生物标志物，特别是活性基质金属蛋白酶-8（aMMP-8），在唾液/口腔冲洗液中是一种有前途的牙周健康和疾病的诊断方法。不同的口腔液有其特定的优点和局限性。本研究旨在探讨不同采样方法对 aMMP-8 即时检验（POCT）准确性的影响。
连续 95 名成年人依次采集未刺激全唾液、首次和第二次口腔冲洗液。使用侧向流动免疫测定法（指数试验）定量测定 aMMP-8。根据 2017 年世界牙周病工作组（Worl Workshop on Periodontology，WWP）分类标准，采用全口牙周检查建立诊断（参考标准）。评估和比较了受试者工作特征曲线（receiver operating characteristic curve，ROC）下面积（area under the receiver operating characteristic curve，AUROC）、敏感性和特异性等诊断指标。
在所有口腔液样本中，与牙周健康或牙龈炎患者（N=34）相比，牙周炎患者（N=61）的 aMMP-8 水平明显升高，检测阳性率也更高。个体内比较显示，与其他样本相比，首次口腔冲洗液中的 aMMP-8 水平明显更高（1 次口腔冲洗液＞唾液＞2 次口腔冲洗液，p=0.007）。使用首次口腔冲洗液的 aMMP-8 检测在检测牙周炎方面具有最佳的准确性，其敏感性为 80.3%，特异性为 67.8%，AUROC 为 0.740。
使用不含预冲洗的 30 秒水漱口可以最佳地提高 aMMP-8 POCT 区分牙周健康和疾病的准确性。这种方案似乎很有希望在更大的代表性人群中进一步研究来验证目前的发现。
