Kosaka Takayuki, Fushida Shuri, Wada Masahiro, Gonda Tomoya, Hatta Kodai, Kuboniwa Masae, Wada Arisa, Hashimoto Sumiyo, Hatanaka Hiromi, Higashi Makiko, Kikuchi Takeshi, Terauchi Keiji, Kido Michiko, Akagi Yuya, Kamide Kei, Kabayama Mai, Ikebe Kazunori
Department of Removable Prosthodontics and Gerodontology, Graduate School of Dentistry, The University of Osaka, Osaka 565-0871, Japan.
Department of Preventive Dentistry, Graduate School of Dentistry, The University of Osaka, Osaka 565-0871, Japan.
J Clin Med. 2025 Jul 14;14(14):4965. doi: 10.3390/jcm14144965.
This study aimed to evaluate the effectiveness of a saliva-based screening method for periodontal disease among community-dwelling older adults in Japan. : A total of 372 study participants (mean age: 73.1 years) with 20 or more remaining teeth were included in the study. Of the six parameters assessed by the Salivary Multi Test (SMT), this study focused on the three parameters related to periodontal disease: occult blood, leukocytes, and proteins. Periodontal tissue examinations were performed based on the Community Periodontal Index (CPI) using partial mouth recording. To evaluate screening accuracy, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each of the three markers: occult blood, leukocytes, and proteins. Receiver operating characteristic (ROC) analysis was performed for each SMT item, and area under the curve (AUC) was calculated. Logistic regression analysis was used to calculate the odds ratios for combinations of SMT markers, with the presence of periodontal pockets and gingival inflammation as the respective outcome variables. : Among the individual markers, occult blood showed the highest diagnostic performance for detecting both periodontal pockets and gingival inflammation. The combination of elevated occult blood and leukocyte levels yielded the highest odds ratios for both periodontal pockets and gingival inflammation. : While several SMT markers showed associations with periodontal conditions, their utility for screening in older Japanese adults remains to be further validated. Combining markers may help improve diagnostic performance, but additional studies are warranted.
本研究旨在评估一种基于唾液的筛查方法对日本社区居住老年人牙周疾病的有效性。共有372名剩余牙齿20颗及以上的研究参与者(平均年龄:73.1岁)纳入本研究。在唾液多项检测(SMT)评估的六个参数中,本研究重点关注与牙周疾病相关的三个参数:潜血、白细胞和蛋白质。基于社区牙周指数(CPI)采用部分口腔记录进行牙周组织检查。为评估筛查准确性,计算了潜血、白细胞和蛋白质这三个标志物各自的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)。对每个SMT项目进行了受试者工作特征(ROC)分析,并计算了曲线下面积(AUC)。采用逻辑回归分析计算SMT标志物组合的比值比,以牙周袋的存在和牙龈炎症作为各自的结局变量。在单个标志物中,潜血在检测牙周袋和牙龈炎症方面表现出最高的诊断性能。潜血和白细胞水平升高的组合在牙周袋和牙龈炎症方面产生的比值比最高。虽然几种SMT标志物与牙周状况有关,但其在日本老年成年人筛查中的效用仍有待进一步验证。联合使用标志物可能有助于提高诊断性能,但仍需更多研究。