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Dental Peri-Implant Point-of-Care Tests
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Dental Peri-Implant Point-of-Care Tests

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 20194

Special Issue Editor

Prof. Dr. Timo Sorsa

E-Mail Website
Guest Editor
Department of Oral and Maxillofacial Diseases, Helsinki University and Helsinki University Central Hospital, 00290 Helsinki, Finland
Interests: periodontitis; matrix metalloproteinase (MMP-8) and related factors; synthetic MMP-inhibitors; chair-side/bed-side/point-of-care MMP-diagnostic tests in periodontitis and related systemic diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues:

Currently, the diagnosis of both periodontal and peri-implant diseases is mainly based on the clinical measurement of pocket depths, attachment loss, and bleeding on probing, together with radiographic examination. These diagnostic procedures can assess only past tissue destruction and do not provide any information about the current disease states and activities or future risk of progression. Therefore, the need for potential biomarkers emerges in order to screen the susceptible sites and patients in order to intervene in a timely manner and prevent irreversible periodontal and dental peri-implant tissue destruction in both periodontitis and dental peri-implantitis.

Point-of-care tests are simple medical tests that can be performed at the bedside. Point-of-care tests are often accomplished through the use of transportable, portable, and handheld instruments. Cheaper, faster, and smarter point-of-care tests devices have increased the use of Point-of-care tests approaches by making it cost-effective for many diseases. Additionally, it is very desirable to measure various analytes simultaneously in the same specimen, allowing rapid, low-cost, and reliable quantification. Therefore, Point-of-care testing has become more important for medical diagnostics in the last decade. In this context, and in view of the latest advances in translational research on periodontal and peri-implant disease biomarkers, point-of-care technologies are emerging as new tools to target periodontitis and peri-implantitis. In particular, these technologies could help to pinpoint the crucial transition of gingivitis or subclinical periodontitis without clinical or radiographic manifestations to active periodontal disease, with progressive deepened pockets and attachment loss.

Prof. Dr. Timo Sorsa
Guest Editor

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Published Papers (5 papers)

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Research

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11 pages, 1514 KiB  
Communication
Active MMP-8 Quantitative Test as an Adjunctive Tool for Early Diagnosis of Periodontitis
by Marcela Hernández, Mauricio Baeza, Ismo T. Räisänen, Johanna Contreras, Taina Tervahartiala, Alejandra Chaparro, Timo Sorsa and Patricia Hernández-Ríos
Diagnostics 2021, 11(8), 1503; https://doi.org/10.3390/diagnostics11081503 - 20 Aug 2021
Cited by 17 | Viewed by 3726
Abstract
Periodontitis is a host-mediated bacterial disease that affects the tooth attachment apparatus. Metalloproteinase-8 (MMP-8), a validated biomarker, could aid in clinical diagnosis. This study aimed to evaluate the diagnostic performance of active (a) MMP-8 immunotest versus total (t) MMP-8 ELISA for quantitative real-time [...] Read more.
Periodontitis is a host-mediated bacterial disease that affects the tooth attachment apparatus. Metalloproteinase-8 (MMP-8), a validated biomarker, could aid in clinical diagnosis. This study aimed to evaluate the diagnostic performance of active (a) MMP-8 immunotest versus total (t) MMP-8 ELISA for quantitative real-time diagnosis and assessment of periodontitis severity at the site level. Gingival crevicular fluid (GCF) was sampled from 30 healthy, 42 mild, and 59 severe periodontitis sites from thirty-one volunteers. MMP-8 concentrations were determined by time-resolved immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using the STATA package. Both active and total MMP-8-based methods discriminated among sites according to periodontal diagnosis and severity, with a positive correlation between the two tests (p < 0.001). (a) MMP-8 models showed the best performance in receiver operating characteristic (ROC) curves to discriminate between healthy and periodontitis sites (area under the curve [AUC] = 0.89), while (t) MMP-8 demonstrated a high diagnostic precision in the detection of mild from severe periodontitis sites (AUC ≥ 0.80). The use of (a) MMP-8 and (t) MMP-8 could represent a useful adjunctive tool for periodontitis diagnosis and severity. These results support the applicability of new point-of-care methods in the monitoring of high-risk periodontal patients. Full article
(This article belongs to the Special Issue Dental Peri-Implant Point-of-Care Tests)
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12 pages, 744 KiB  
Communication
aMMP-8 Point-of-Care/Chairside Oral Fluid Technology as a Rapid, Non-Invasive Tool for Periodontitis and Peri-Implantitis Screening in a Medical Care Setting
by Hanna Lähteenmäki, Kehinde A. Umeizudike, Anna Maria Heikkinen, Ismo T. Räisänen, Nilminie Rathnayake, Gunnar Johannsen, Taina Tervahartiala, Solomon O. Nwhator and Timo Sorsa
Diagnostics 2020, 10(8), 562; https://doi.org/10.3390/diagnostics10080562 - 5 Aug 2020
Cited by 36 | Viewed by 4564
Abstract
This communication article addresses currently available rapid non-invasive methods to screen and detect periodontitis and dental peri-implantitis. In this regard, oral fluid biomarkers have been researched extensively but self-reported oral health (SROH)-questionnaires have also been developed. Both alternatives may offer a quick and [...] Read more.
This communication article addresses currently available rapid non-invasive methods to screen and detect periodontitis and dental peri-implantitis. In this regard, oral fluid biomarkers have been researched extensively but self-reported oral health (SROH)-questionnaires have also been developed. Both alternatives may offer a quick and easy way to screen and detect diseased patients. Active matrix metalloproteinase (aMMP-8) is one of the most validated biomarkers for screening and detecting periodontal breakdown related to periodontitis and peri-implantitis and monitoring their treatment effects revealing successful, less- and non-successful treatment results. Currently available aMMP-8 lateral-flow technologies allow this kind of analysis, as demonstrated here, to be conducted quantitatively online and real-time as point-of-care/chairside testing in dental and even medical care settings. In this study, an aMMP-8 peri-implant sulcular fluid point-of-care-test diagnosed peri-implantitis and healthy implants far more accurately than bleeding-on-probing or the other biomarkers, such as polymorphonuclear (PMN)/neutrophil elastase, myeloperoxidase and MMP-9. Although, SROH-questionnaires allow screening in similar settings but they lack the information about the current disease activity of periodontitis and peri-implantitis, which is of essential value in periodontal diagnostics and treatment monitoring. Thus, both methods can be considered as adjunct methods for periodontitis and peri-implant diagnostics, but the value of oral fluid biomarkers analysis does not seem to be substitutable. Full article
(This article belongs to the Special Issue Dental Peri-Implant Point-of-Care Tests)
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12 pages, 248 KiB  
Article
Immunological and Microbiological Profiling of Cumulative Risk Score for Periodontitis
by Joonas Liukkonen, Ulvi K. Gürsoy, Eija Könönen, Ramin Akhi, Aino Salminen, John M. Liljestrand, Pratikshya Pradhan-Palikhe, Milla Pietiäinen, Timo Sorsa, G. Rutger Persson, Päivi Mäntylä, Kåre Buhlin, Susanna Paju, Juha Sinisalo, Sohvi Hörkkö and Pirkko J. Pussinen
Diagnostics 2020, 10(8), 560; https://doi.org/10.3390/diagnostics10080560 - 5 Aug 2020
Cited by 10 | Viewed by 2925
Abstract
The cumulative risk score (CRS) is a mathematical salivary diagnostic model to define an individual’s risk of having periodontitis. In order to further validate this salivary biomarker, we investigated how periodontal bacteria, lipopolysaccharide (LPS), and systemic and local host immune responses relate to [...] Read more.
The cumulative risk score (CRS) is a mathematical salivary diagnostic model to define an individual’s risk of having periodontitis. In order to further validate this salivary biomarker, we investigated how periodontal bacteria, lipopolysaccharide (LPS), and systemic and local host immune responses relate to CRS. Subgingival plaque, saliva, and serum samples collected from 445 individuals were used in the analyses. Plaque levels of 28 microbial species, especially those of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia, and Tannerella forsythia, and serum and salivary levels of IgA and IgG against these five species were determined. Additionally, LPS activity was measured. High CRS associated strongly with all IgA/IgG antibody and LPS levels in saliva, whereas in serum the associations were not that obvious. In the final logistic regression model, the best predictors of high CRS were saliva IgA burden against the five species (OR 7.04, 95% CI 2.25–22.0), IgG burden (3.79, 1.78–8.08), LPS (2.19, 1.38–3.47), and the sum of 17 subgingival Gram-negative species (6.19, 2.10–18.3). CRS is strongly associated with microbial biomarker species of periodontitis and salivary humoral immune responses against them. Full article
(This article belongs to the Special Issue Dental Peri-Implant Point-of-Care Tests)

Review

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28 pages, 1879 KiB  
Review
Diagnostic Accuracy of Oral Fluids Biomarker Profile to Determine the Current and Future Status of Periodontal and Peri-Implant Diseases
by Sarhang S. Gul, Ali A. Abdulkareem, Aram M. Sha and Andrew Rawlinson
Diagnostics 2020, 10(10), 838; https://doi.org/10.3390/diagnostics10100838 - 18 Oct 2020
Cited by 49 | Viewed by 5679
Abstract
Severe periodontitis is ranked as the sixth most prevalent disease affecting humankind, with an estimated 740 million people affected worldwide. The diagnosis of periodontal diseases mainly relies upon assessment of conventional clinical parameters. However, these parameters reflect past, rather than current, clinical status [...] Read more.
Severe periodontitis is ranked as the sixth most prevalent disease affecting humankind, with an estimated 740 million people affected worldwide. The diagnosis of periodontal diseases mainly relies upon assessment of conventional clinical parameters. However, these parameters reflect past, rather than current, clinical status or future disease progression and, likely, outcome of periodontal treatment. Specific and sensitive biomarkers for periodontal diseases have been examined widely to address these issues and some biomarkers have been translated as point-of-care (PoC) tests. The aim of this review was to provide an update on PoC tests for use in the diagnosis and management of periodontal diseases. Among the PoC tests developed so far, active matrix metalloproteinase-8 has shown promising results in terms of diagnostic and prognostic values. However, further studies are required to increase the sensitivity and specificity via combining more than one biomarker and merging these test kits with periodontal risk assessment tools. Furthermore, the validity of these test kits needs to be investigated by applying the results in further independent studies and the impact on these test kits’, together with the results of risk factors for periodontal diseases, such as diabetes and smoking, also needs to be examined. Full article
(This article belongs to the Special Issue Dental Peri-Implant Point-of-Care Tests)
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Other

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7 pages, 435 KiB  
Commentary
An Unexplored Pharmacologic/Diagnostic Strategy for Peri-Implantitis: A Protocol Proposal
by Lorne M. Golub, Ismo T. Räisänen, Timo Sorsa and Philip M. Preshaw
Diagnostics 2020, 10(12), 1050; https://doi.org/10.3390/diagnostics10121050 - 5 Dec 2020
Cited by 14 | Viewed by 2435
Abstract
Dental implants are widely utilized for the replacement of missing teeth and are increasingly being placed in patients with systemic diseases, as well as in those who are medically healthy. Furthermore, it is recognized that peri-implant mucositis and peri-implantitis are highly prevalent, affecting [...] Read more.
Dental implants are widely utilized for the replacement of missing teeth and are increasingly being placed in patients with systemic diseases, as well as in those who are medically healthy. Furthermore, it is recognized that peri-implant mucositis and peri-implantitis are highly prevalent, affecting large numbers of patients with implants, and it is pertinent to consider whether there may be any systemic impact of these conditions, given that there are known links between periodontitis and a number of chronic inflammatory diseases. In this article, we propose that the potential systemic complications of peri-implant diseases should be investigated in future clinical research, together with studies to identify whether systemically-administered host modulation therapies (HMTs) may be of benefit in the treatment of peri-implant diseases. These “HMTs” may prove a useful adjunct to routinely employed debridement and disinfection protocols, as well as potentially being of benefit in reducing risks of systemic complications. We also consider the use of chair-side diagnostic tests for active matrix metalloproteinase-8 (aMMP-8) in the detection of peri-implant disease given the ability of such tests to detect active tissue breakdown associated with peri-implantitis and periodontitis before conventional clinical and radiographic measurements indicate pathologic changes. These novel diagnostic and therapeutic strategies are relevant to consider as they may improve the management of peri-implant disease (beyond local debridement procedures), especially in those patients in whom systemic inflammation might be of concern. Full article
(This article belongs to the Special Issue Dental Peri-Implant Point-of-Care Tests)
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